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: 01/09/23

Service Code
Description
Standard Fee
D0350
2D Oral/Facial Photography Image
$53
D1110
Adult Prophylaxis
$93
D0150
Comprehensive Exam
$119
D2331
Composite Filling - 2 SF, Anterior
$214
D0210
Full Mouth X-Rays
$138
D9944
Occlusal Guard
$528
D7250
Surgical Removal Residual Root
$288
D2392
Composite - 2 SUR, Posterior
$263
D7210
Surgical Extraction Erupted Tooth
$282
D2330
Composite Filling - 1 SF, Anterior
$170
D5512
Repair Broken Complete Denture Base, Maxillary
$290
D0140
Limited Exam
$96
D0120
Recall Examination
$56
D0220
Periapical X-Ray, First Film
$29
D0230
Periapical X-Ray, Add. Film
$23

Joseph A. Lucero DDS Inc.

2575 Park Lane, Suite 101

Lafayette, CO 80026

bottom of page