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A Dental Code Price List Has Four Prices Per Code

A dental code price list is really four lists: your office fee, each payer's allowable, the plan's share, and what the patient owes. Here is how to build one.

There is no single dental code price list. Every CDT code carries at least four different numbers: the fee your office charges, the allowable each payer has contracted you to accept, the portion the plan actually pays once the category percentage, the deductible and the annual maximum are applied, and the balance that lands on the patient. The lists you find published online are almost always the first number for one practice, or a state Medicaid schedule. Treating any of them as the price is how a confident estimate falls apart on the remittance.

Here is how to build the four lists you need.

Four prices hang off every CDT code

Take D2740, crown - porcelain/ceramic. The figures below are illustrative, chosen for clean arithmetic, not a survey.

Number Where it comes from Illustrative D2740
Office fee, also called the full fee or UCR fee Set by the practice, loaded in your software 1,400
Contracted allowable The signed fee schedule for that payer, plan and location 950
Plan's share, major at 50 percent, deductible met, under the annual maximum The plan design, not the fee schedule 475
Patient responsibility 950 minus 475 475
Contractual write off 1,400 minus 950 450

Only one of those numbers belongs to you. The office fee is yours. The allowable belongs to the contract. The plan's share belongs to the employer group that bought the plan. The patient balance is what falls out of the other three. That is why two patients in the same chair on the same day, for the same code, correctly owe different amounts.

Do dentists have price lists?

Yes. Every practice keeps a full fee schedule in its practice management software, one office fee for every CDT code it bills. Any front desk can pull the fee for a planned procedure in seconds, and most will quote it on request.

What an office cannot print is one list of what a patient will pay. The office fee is the starting point, and the plan subtracts from it four ways: the contracted allowable, the coverage percentage for that category, the remaining deductible, and the remaining annual maximum. Frequency limits and alternate benefit clauses cut it further.

Two practical points:

  • Quote the office fee plainly for uninsured and self pay patients. Federal good faith estimate rules for uninsured and self pay patients have been in effect since January 2022, and some states add written estimate requirements of their own. As of this writing, confirm with your state dental board and state insurance department how those apply in your state.
  • Never quote a range you have not verified for that plan. A patient who hears "crowns run eight hundred to fifteen hundred" will remember eight hundred.

Why is my root canal $3000?

Because a root canal is almost never one code. The patient is looking at a bundle and reading it as one procedure. Break it into lines and the number stops feeling arbitrary.

CDT code Nomenclature Illustrative office fee
D0140 limited oral evaluation - problem focused 90
D0220 intraoral - periapical first radiographic image 35
D3330 endodontic therapy, molar tooth (excluding final restoration) 1,300
D2950 core buildup, including any pins when required 300
D2740 crown - porcelain/ceramic 1,400
Total office fee for the tooth 3,125

Three things drive the spread between quotes.

Tooth position. Endodontic therapy is coded by tooth type and the fees step up: D3310 anterior, D3320 premolar, D3330 molar. A molar has more canals and more chair time, so a molar quote and an anterior quote are not comparable numbers.

The final restoration. D3330 is explicitly "excluding final restoration." The crown that follows is a separate code, a separate fee and usually a separate benefit category. A patient quoted 1,300 for the endodontic therapy alone was not quoted the finished tooth.

The contract behind it. An endodontist's fee schedule differs from a general dentist's, and an in-network allowable differs from an out-of-network fee. Same code, same tooth, different number.

What are the new dental charges for 2026?

Two unrelated things change at the turn of a year, and practices often collapse them into one.

The code set changes. CDT is revised annually, effective January 1. Codes are added, nomenclature is revised, retired codes stop being valid. The rule is absolute: bill the code set in effect on the date of service. A code deleted January 1 will reject on a claim dated January 2, even if the plan was written in November.

Fees change on two different clocks. Your office fees update when you decide to update them. Payer fee schedules update on the payer's cycle, often the contract anniversary rather than the calendar year, and the revised schedule is not always pushed to you. Request the current one in writing for every contracted plan once a year, then compare it line by line against what is loaded in your software.

Check one more code set while you are in there. The denial and remark codes on remittances are CARC and RARC values, maintained separately, and they are how a payer tells you why an allowed amount came in low. Our guide to CARC, RARC, and CAGC codes for dental teams covers reading them.

What are the 31 new dental codes for 2026?

Treat any specific count in a search result, that one included, as unverified. Counts circulating online mix additions with revisions and deletions, and get quoted from drafts before the American Dental Association's Code Maintenance Committee actions are final. A list of "new codes" copied from a forum into a practice management system is a rejection waiting to happen.

Do this instead, in the last two weeks of December:

  1. Pull the official CDT change summary from the ADA, which publishes additions, revisions and deletions together.
  2. Export the codes your practice actually billed in the past twelve months, sorted by volume. For most general practices that is roughly forty codes, the top fifteen carrying most of the revenue.
  3. Act only on the intersection. A new implant maintenance code matters if you place implants and is noise if you do not.
  4. Update those codes in your software, nomenclature included, then watch the first two weeks of January remittances on them.

Nomenclature revisions deserve the most attention, because they change what a code means without changing its number. A code billed the same way for three years can quietly stop describing what you do, and that drift becomes an upcoding allegation. Our guide to overcoming a dental claim denial for upcoding covers how those get argued.

Where the real numbers for your ZIP code come from

Patients search "dental fees by ZIP code" and land on aggregated charge data. Practices need something sturdier. Four sources, ranked by how much they should drive your pricing:

Your remittances. The allowed amount that actually posted, per code, per payer, over the last several months, is ground truth. It already reflects the current schedule, any bundling and any downgrade.

Your signed fee schedules. Authoritative for what you agreed to, as of the date issued. Request them annually in writing and date stamp what arrives.

Regional survey and charge data. The ADA Health Policy Institute publishes survey research on dental fees, and FAIR Health publishes charge data by geography. Both help you judge whether your office fees sit sensibly for your region. Neither tells you what a plan will allow.

Payer estimators and state Medicaid schedules. Payer tools are built for members and return ranges. State Medicaid schedules are precise but apply only to that program.

The money leaks in the gap between the second source and the first, the schedule you believe you have versus the amount that posted. Curo reads the allowed amount on every remittance line, compares it to the contracted rate you were promised for that code, and flags the ones that came in short, which is also how it learns what each payer truly pays you. Our EOB reconciliation page shows that in practice.

The codes worth pinning per payer

You do not need a verified allowable for all of CDT. You need it for the codes that move money and the codes that argue.

Code Nomenclature Why it needs its own answer per plan
D1110 prophylaxis - adult Interacts with D4910 frequency once a patient has perio history
D4346 scaling in presence of generalized moderate or severe gingival inflammation - full mouth, after oral evaluation Category placement varies by plan, preventive for some, basic for others, excluded on some. Verify by name
D2740 crown - porcelain/ceramic Material downgrades and waiting periods both land here
D2950 core buildup, including any pins when required Often bundled into the crown allowance rather than allowed separately
D2391 resin-based composite - one surface, posterior The classic alternate benefit target, paid at the amalgam rate under many plans
D9230 inhalation of nitrous oxide/anxiolysis, analgesia Often non-covered, making the office fee the patient's price
D8080 comprehensive orthodontic treatment of the adolescent dentition Lifetime maximum, not annual, paid on a banding and monthly schedule

On the big cases there, a predetermination turns an estimate into writing before the patient commits. Our walkthrough of getting a predetermination approved applies well beyond veneers, and the buyer's guide to dental prior authorization software covers doing it at volume. Ortho runs on its own arithmetic, and disputing an orthodontic denial is a separate conversation.

What to hand the patient

A price list, in the sense the patient means it, is a treatment plan with the codes itemized, the office fee beside each line, the estimated plan payment beside that, and one total labeled clearly as an estimate based on benefits verified on a stated date.

That page beats any published fee table, because it is the only version of the price that is true for that person, that plan and that tooth. Print it, date it, keep the copy. When the remittance comes back different, the dated estimate tells you which of the four numbers moved.

Frequently asked questions

Do dentists have price lists?

Yes. Every practice keeps a full fee schedule in its practice management software, one office fee per CDT code, and will give you the fee for a planned procedure on request. What most offices cannot hand you is a single list of what you will pay, because that depends on your plan's allowable, your remaining deductible, your annual maximum and the category percentage for that code.

What are the new dental charges for 2026?

Two separate things change at the start of a year. The CDT code set is revised effective January 1, so some codes are added, some are revised and some retire. Separately, practices update their own office fees and payers issue revised contracted fee schedules on their own cycles. Neither change is automatic in your software, and both have to be loaded by hand and verified.

Why is my root canal $3000?

Because a root canal is rarely one code. A molar case commonly bills a problem focused exam, a periapical image, endodontic therapy on the molar, a core buildup and then a crown, each with its own fee. Tooth position also drives the endodontic fee, since molars cost more than premolars and premolars more than anterior teeth. Ask for the itemized codes before you compare quotes.

What are the 31 new dental codes for 2026?

Counts circulating online usually mix additions with revisions and deletions, and they change as the American Dental Association's Code Maintenance Committee finalizes its actions. Do not load a list you found in a forum. Pull the official CDT 2026 change summary from the ADA, compare it against the codes your practice actually bills, and update only those in your software before January 1.

How do I look up the price for a specific dental code like D2740?

There is no national price for D2740, the code for a porcelain or ceramic crown. Look up three numbers instead: your own office fee in your software, the contracted allowable on the signed fee schedule for that payer and plan, and the allowed amount that actually posted on your last several remittances for that code. The third number is the one that has proven itself.

Sources

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