top of page

Common Procedure Codes

The following chart displays our offices 15 most common procedure codes. We will update this monthly to ensure that patients can refer to this chart for any questions. Please feel free to call our office if you would like more information about our fees.

Updated: 06/05/2023

Service Code
Description
Standard Fee
D0350
2D/Facial Photography Image
$60
D7140
Extraction Erupted Tooth
$165
D9310
Consultation/Second Opinion
$130
D1110
Adult Prophylaxis
$94
D7210
Surgical Extraction Erupted Tooth
$283
D0210
Full Mouth X-Rays
$139
D0160
Detailed and Extensive Oral Evaluation
$129
D0230
Periapical X-Ray ADD. Film
$24
D0150
Comprehensive Exam
$119
D0330
Panoramic X-Ray
$105
D0220
Periapical X-Ray, First Film
$29
D0470
Diagnostic Casts
$101
D0274
Bitewing X-Rays, 4 Films
$63
D4342
Scaling and Root Planning 1-3 Teeth
$196
D1206
Fluoride Varnish
$44

Joseph A. Lucero DDS Inc.

2575 Park Lane, Suite 101

Lafayette, CO 80026

bottom of page