Dental fees

Effective 1 July 2022

Dental services can be invoiced online via LanternPay for next business day payments.

For dental services provided on or after 1 July 2022
GeneralSpecialist
Service DescriptionADA NumberMaximum
Payment
Rate
Maximum
Payment
Rate
Diagnostic services
Comprehensive Oral Examination 011 $103.13 $103.13
Periodic Oral Examination 012 $65.19 $65.19
Consultation 014 $103.13 $103.13
Written report (not elsewhere included) 018 $143.49 $188.88
Intraoral periapical or bitewing radiograph - per exposure 022 $50.80 $50.80
Cone Beam Volumetric Tomography - scan acquisition - per appointment 026 $162.16 $162.16
Cephalometric Radiograph - per exposure 036 $114.64 $114.64
Panoramic radiograph - per exposure 037 $114.64 $114.64
Pulp Testing - per appointment 061 $36.87 $36.87
Diagnostic model - per model 071 $71.34 $71.34
Photographic records - intraoral - per appointment 072 $40.74 $40.74
Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) 089 $75.68 $75.68
Preventive Services
(Prior approval from TAC required for these services)
Removal Of Calculus - first appointment 114 $128.13          $128.13
Bleaching, Internal - per tooth 117 $227.35 $227.35
Topical application of remineralisation and/or cariostatic agents - one treatment 121 $46.75 $46.75
Oral hygiene instruction 141 $51.10 $51.10
Desensitising Procedure - per appointment 165 $48.13 $48.13
Odontoplasty - per tooth 171 $51.49 $51.49
Periodontal Debridement - per tooth 222 $58.38 $67.13         
Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period 232 $288.29           $288.29          
Surgical treatment of Peri-implant Disease - per implant 233 $347.83 $347.83
Gingival Graft - per tooth, implant or extraction 235 $501.97 $590.56
Guided Tissue Regeneration - per tooth or implant 236 $501.97 $590.56          
Guided Tissue Regeneration - membrane removal 237 $583.13          $686.05
Periodontal Surgery for Crown Lengthening - per tooth 238 $504.33 $593.33
Osseous Graft- per tooth or implant 243 $501.97 $590.56
Oral Surgery
Removal of a tooth or part(s) thereof 311 $213.49 $230.87
Sectional removal of tooth or part(s) thereof 314 $281.35 $287.20
Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division 322 $316.52 $331.37
Surgical removal of a tooth or tooth fragment requiring removal of bone 323 $381.13 $407.58
Splinting of displaced tooth/teeth - per tooth 386 $209.88 $262.76
Replantation and splinting of a tooth - per tooth 387 $421.95 $485.24
Endodontics
(These fees include the cost of x-rays where required)    
Direct Pulp Capping 411 $56.84 $59.65
Pulpotomy 414 $140.23 $191.61
Complete chemo-mechanical preparation of root canal - one canal 415 $327.89 $377.06
Complete chemo-mechanical preparation of root canal - each additional canal 416 $161.39 $187.02
Root canal obturation - one canal 417 $321.81 $370.07
Root canal obturation - each additional canal 418 $158.75 $182.55
Extirpation of pulp or debridement of root canal(s) - emergency or palliative 419 $225.18 $225.18
Removal Of Root Filling - Per Canal 451 $153.50 $176.54
Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth 455 $169.97 $195.46
Restorative Services   
Metallic Restoration - One Surface - direct 511 $167.69 $192.84
Metallic Restoration - Two Surfaces - direct 512 $200.41 $230.47
Metallic Restoration - Three Surfaces - direct 513 $234.65 $269.86
Metallic Restoration - Four Surfaces - direct 514 $269.17 $309.55
Metallic Restoration - Five Surfaces - direct 515 $305.67 $351.51
Adhesive Restoration - One Surface - Anterior Tooth - direct 521 $180.30 $207.34
Adhesive Restoration - Two Surfaces - Anterior tooth - direct 522 $212.05 $243.88
Adhesive Restoration - Three Surfaces - Anterior tooth - direct 523 $248.85 $286.18
Adhesive Restoration - Four Surfaces - Anterior tooth - direct 524 $279.98 $321.99
Adhesive Restoration - Five Surfaces - Anterior tooth - direct 525 $329.33 $378.72
Adhesive Restoration - Veneer - Anterior tooth- direct 526 $371.09 $407.54
Adhesive restoration - one surface - posterior tooth - direct 531 $190.09 $218.60
Adhesive restoration - two surfaces - posterior tooth - direct 532 $226.44 $260.41
Adhesive restoration - three surfaces - posterior tooth - direct 533 $264.85 $304.58
Adhesive restoration - four surfaces - posterior tooth - direct 534 $298.36 $343.12
Adhesive restoration - five surfaces - posterior tooth - direct 535 $355.52 $408.85
Adhesive Restoration - Veneer - Posterior tooth - direct 536 $364.30 $407.54
Tooth coloured restoration - one surface - indirect 551 $917.77 $1,055.45
Tooth coloured restoration - two surfaces - indirect 552 $1,017.23 $1,169.82
Tooth coloured restoration - three surfaces - indirect 553 $1,175.06 $1,351.32
Tooth coloured restoration - four surfaces - indirect 554 $1,275.59 $1,466.93
Tooth coloured restoration - five surfaces - indirect 555 $1,398.83 $1,608.65
Tooth - coloured restoration - Veneer - indirect 556 $1,342.62 $1,544.01
Provisional (intermediate/temporary) restoration - per tooth 572 $98.38 $98.38
Pin retention - per pin 575 $44.46 $44.46
Post - Direct 597 $182.27 $204.96
Crown and Bridgework
(If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC)
Full crown - non metallic - indirect 613 $1,580.01 $1,817.02
Full crown - veneered - indirect 615 $1,558.60 $1,792.39
Full crown - metallic indirect 618 $1,568.33 $1,803.57
Post and core for crown - indirect 625 $493.41 $593.33
Preliminary restoration for crown - direct 627 $275.81 $293.07
Provisional bridge pontic - per pontic 632 $312.59 $312.59
Bridge pontic - direct - per pontic 642 $406.98 $468.03
Bridge pontic - indirect - per pontic 643 $1,175.35 $1,586.72
Retainer for bonded fixture - indirect - per tooth 649 $698.23 $802.96
Implant Procedures
Fitting of an implant abutment - per abutment 661 $1,008.01 $1,008.01
Prosthesis with metal frame attached to implants - fixed - per arch 666 $3,632.20 $5,321.85
Removal and reattachment of prosthesis fixed to implant(s) – per implant 669 $175.01 $175.01
Full crown attached to osseointegrated implant - veneered indirect 672 $2,009.60 $2,638.08
Surgical implant guide 679 $238.83 $238.73
Insertion of first stage of two-stage endosseous implant - per implant 684 $2,162.02 $2,162.02
Insertion of one stage endosseous implant - per implant
Includes the cost of hardware
688 $2,609.02 $2,609.02
Second stage surgery of two stage endosseous implant - per implant
Includes the cost of hardware
691 $446.88 $446.88
Prosthodontics
Complete Maxillary Denture 711 $1,448.71 $1,666.01
Complete Mandibular Denture 712 $1,448.71 $1,666.01
Complete Maxillary and Mandibular Denture 719 $2,627.03 $3,021.08
Partial maxillary denture - resin base 721 $930.21 $930.21
Partial mandibular denture - resin base 722 $930.21 $930.21
Partial maxillary denture - cast metal framework including rests and retainers 727 $1,613.95 $1,856.05
Partial mandibular denture - cast metal framework including rests and retainers 728 $1,613.95 $1,856.05
Additional items for Acrylic Dentures only
Retainer - Per Tooth 731 $58.29 $58.29
Occlusal Rest - per rest 732 $16.90 $16.90
Tooth/teeth partial denture 733 $57.30 $57.30
Immediate tooth replacement - per tooth 736 $11.37 $11.37
Relining - complete denture - processed 743 $456.19 $456.19
Relining - partial denture - processed 744 $444.04 $444.04
Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth 768 $197.72 $229.75
Splint  - Resin - Indirect772$298.13$421.95
Orthodontics
Active removable appliance therapy - per arch 821 $1,043.27 $1,196.27
Full arch banding - per arch 831 $2,876.57 $4,111.68
Minor tooth guidance - fixed 846 $932.86 $932.86
Complete course of orthodontic treatment 881 $5,942.32 $7,694.50
General
Travel to provide services 916 FBN* FBN*
Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period 963 $98.38 $137.67
Occlusal splint 965 $654.76 $671.14
Adjustment of pre-existing occlusal splint - per appointment 966 $93.26 $119.29
For dental services provided between 1 July 2021 and 30 June 2022
GeneralSpecialist
Service DescriptionADA NumberMaximum
Payment
Rate
Maximum
Payment
Rate
Diagnostic services
Comprehensive Oral Examination 011 $100.59 $100.59
Periodic Oral Examination 012 $63.58 $63.58
Consultation 014 $100.59 $100.59
Written report (not elsewhere included) 018 $139.95 $184.22
Intraoral periapical or bitewing radiograph - per exposure 022 $49.55 $49.55
Cone Beam Volumetric Tomography - scan acquisition - per appointment 026 $158.16 $158.16
Cephalometric Radiograph - per exposure 036 $111.81 $111.81
Panoramic radiograph - per exposure 037 $111.81 $111.81
Pulp Testing - per appointment 061 $35.96 $35.96
Diagnostic model - per model 071 $69.58 $69.58
Photographic records - intraoral - per appointment 072 $39.73 $39.73
Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) 089 $73.81 $73.81
Preventive Services
(Prior approval from TAC required for these services)
Removal Of Calculus - first appointment 114 $124.97      $124.97
Bleaching, Internal - per tooth 117 $221.74 $221.74
Topical application of remineralisation and/or cariostatic agents - one treatment 121 $45.60 $45.60
Oral hygiene instruction 141 $49.84 $49.84
Desensitising Procedure - per appointment 165 $46.94 $46.94
Odontoplasty - per tooth 171 $50.22 $50.22
Periodontal Debridement - per tooth 222 $56.94  $65.47     
Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period 232 $281.18    $281.18     
Surgical treatment of Peri-implant Disease - per implant 233 $339.25 $339.25
Gingival Graft - per tooth, implant or extraction 235 $489.58 $575.99
Guided Tissue Regeneration - per tooth or implant 236 $489.58 $575.99   
Guided Tissue Regeneration - membrane removal 237 $568.74     $669.12
Periodontal Surgery for Crown Lengthening - per tooth 238 $491.89 $578.69
Osseous Graft- per tooth or implant 243 $489.58 $575.99
Oral Surgery
Removal of a tooth or part(s) thereof 311 $208.22 $225.17
Sectional removal of tooth or part(s) thereof 314 $274.41 $280.11
Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division 322 $308.71 $323.19
Surgical removal of a tooth or tooth fragment requiring removal of bone 323 $371.73 $397.52
Splinting of displaced tooth/teeth - per tooth 386 $204.70 $256.28
Replantation and splinting of a tooth - per tooth 387 $411.54 $473.27
Endodontics
(These fees include the cost of x-rays where required)    
Direct Pulp Capping 411 $55.44 $58.18
Pulpotomy 414 $136.77 $186.88
Complete chemo-mechanical preparation of root canal - one canal 415 $319.80 $367.76
Complete chemo-mechanical preparation of root canal - each additional canal 416 $157.41 $182.41
Root canal obturation - one canal 417 $313.87 $360.94
Root canal obturation - each additional canal 418 $154.83 $178.05
Extirpation of pulp or debridement of root canal(s) - emergency or palliative 419 $219.62 $219.62
Removal Of Root Filling - Per Canal 451 $149.71 $172.18
Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth 455 $165.78 $190.64
Restorative Services   
Metallic Restoration - One Surface - direct 511 $163.55 $188.08
Metallic Restoration - Two Surfaces - direct 512 $195.46 $224.78
Metallic Restoration - Three Surfaces - direct 513 $228.86 $263.20
Metallic Restoration - Four Surfaces - direct 514 $262.53 $301.91
Metallic Restoration - Five Surfaces - direct 515 $298.13 $342.84
Adhesive Restoration - One Surface - Anterior Tooth - direct 521 $175.85 $202.22
Adhesive Restoration - Two Surfaces - Anterior tooth - direct 522 $206.82 $237.86
Adhesive Restoration - Three Surfaces - Anterior tooth - direct 523 $242.71 $279.12
Adhesive Restoration - Four Surfaces - Anterior tooth - direct 524 $273.07 $314.04
Adhesive Restoration - Five Surfaces - Anterior tooth - direct 525 $321.20 $369.37
Adhesive Restoration - Veneer - Anterior tooth- direct 526 $361.93 $397.48
Adhesive restoration - one surface - posterior tooth - direct 531 $185.40 $213.21
Adhesive restoration - two surfaces - posterior tooth - direct 532 $220.85 $253.98
Adhesive restoration - three surfaces - posterior tooth - direct 533 $258.31 $297.06
Adhesive restoration - four surfaces - posterior tooth - direct 534 $291.00 $334.65
Adhesive restoration - five surfaces - posterior tooth - direct 535 $346.75 $398.76
Adhesive Restoration - Veneer - Posterior tooth - direct 536 $355.31 $397.48
Tooth coloured restoration - one surface - indirect 551 $895.12 $1,029.41
Tooth coloured restoration - two surfaces - indirect 552 $992.13 $1,140.95
Tooth coloured restoration - three surfaces - indirect 553 $1,146.06 $1,317.98
Tooth coloured restoration - four surfaces - indirect 554 $1,244.11 $1,430.73
Tooth coloured restoration - five surfaces - indirect 555 $1,364.31 $1,568.96
Tooth - coloured restoration - Veneer - indirect 556 $1,309.49 $1,505.91
Provisional (intermediate/temporary) restoration - per tooth 572 $95.95 $95.95
Pin retention - per pin 575 $43.36 $43.36
Post - Direct 597 $177.77      $199.90
Crown and Bridgework
(If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC)
Full crown - non metallic - indirect 613 $1,541.02 $1,772.18
Full crown - veneered - indirect 615 $1,520.14 $1,748.16
Full crown - metallic indirect 618 $1,529.63 $1,759.07
Post and core for crown - indirect 625 $481.23 $578.69
Preliminary restoration for crown - direct 627 $269.00 $285.84
Provisional bridge pontic - per pontic 632 $304.88 $304.88
Bridge pontic - direct - per pontic 642 $396.94 $456.48
Bridge pontic - indirect - per pontic 643 $1,146.35 $1,547.57
Retainer for bonded fixture - indirect - per tooth 649 $681.00 $783.15
Implant Procedures
Fitting of an implant abutment - per abutment 661 $983.14 $983.14
Prosthesis with metal frame attached to implants - fixed - per arch 666 $3,542.57 $5,190.53
Removal and reattachment of prosthesis fixed to implant(s) – per implant 669 $170.69 $170.69
Full crown attached to osseointegrated implant - veneered indirect 672 $1,960.01 $2,572.98
Surgical implant guide 679 $232.84 $232.84
Insertion of first stage of two-stage endosseous implant - per implant 684 $2,108.67 $2,108.67
Insertion of one stage endosseous implant - per implant
Includes the cost of hardware
688 $2,544.64 $2,544.64
Second stage surgery of two stage endosseous implant - per implant
Includes the cost of hardware
691 $435.85 $435.85
Prosthodontics
Complete Maxillary Denture 711 $1,412.96 $1,624.90
Complete Mandibular Denture 712 $1,412.96 $1,624.90
Complete Maxillary and Mandibular Denture 719 $2,562.21 $2,946.53
Partial maxillary denture - resin base 721 $907.26 $907.26
Partial mandibular denture - resin base 722 $907.26 $907.26
Partial maxillary denture - cast metal framework including rests and retainers 727 $1,574.12 $1,810.25
Partial mandibular denture - cast metal framework including rests and retainers 728 $1,574.12 $1,810.25
Additional items for Acrylic Dentures only
Retainer - Per Tooth 731 $56.85 $56.85
Occlusal Rest - per rest 732 $16.48 $16.48
Tooth/teeth partial denture 733 $55.89 $55.89
Immediate tooth replacement - per tooth 736 $11.09 $11.09
Relining - complete denture - processed 743 $444.93 $444.93
Relining - partial denture - processed 744 $433.08 $433.08
Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth 768 $192.84 $224.08
Orthodontics
Active removable appliance therapy - per arch 821 $1,017.53 $1,166.75
Full arch banding - per arch 831 $2,805.59 $4,010.22
Minor tooth guidance - fixed 846 $909.84 $909.84
Complete course of orthodontic treatment 881 $5,795.69 $7,504.63
General
Travel to provide services 916 FBN* FBN*
Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period 963 $95.95 $134.27
Occlusal splint 965 $638.60 $654.58
Adjustment of pre-existing occlusal splint - per appointment 966 $90.96 $116.35
For dental services provided on or after 1 July 2022
GeneralSpecialist
Service DescriptionADA NumberMaximum
Payment
Rate
Maximum
Payment
Rate
Diagnostic services
Comprehensive Oral Examination 011 $103.13 $103.13
Periodic Oral Examination 012 $65.19 $65.19
Consultation 014 $103.13 $103.13
Written report (not elsewhere included) 018 $143.49 $188.88
Intraoral periapical or bitewing radiograph - per exposure 022 $50.80 $50.80
Cone Beam Volumetric Tomography - scan acquisition - per appointment 026 $162.16 $162.16
Cephalometric Radiograph - per exposure 036 $114.64 $114.64
Panoramic radiograph - per exposure 037 $114.64 $114.64
Pulp Testing - per appointment 061 $36.87 $36.87
Diagnostic model - per model 071 $71.34 $71.34
Photographic records - intraoral - per appointment 072 $40.74 $40.74
Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) 089 $75.68 $75.68
Preventive Services
(Prior approval from TAC required for these services)
Removal Of Calculus - first appointment 114 $128.13          $128.13
Bleaching, Internal - per tooth 117 $227.35 $227.35
Topical application of remineralisation and/or cariostatic agents - one treatment 121 $46.75 $46.75
Oral hygiene instruction 141 $51.10 $51.10
Desensitising Procedure - per appointment 165 $48.13 $48.13
Odontoplasty - per tooth 171 $51.49 $51.49
Periodontal Debridement - per tooth 222 $58.38 $67.13         
Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period 232 $288.29           $288.29          
Surgical treatment of Peri-implant Disease - per implant 233 $347.83 $347.83
Gingival Graft - per tooth, implant or extraction 235 $501.97 $590.56
Guided Tissue Regeneration - per tooth or implant 236 $501.97 $590.56          
Guided Tissue Regeneration - membrane removal 237 $583.13          $686.05
Periodontal Surgery for Crown Lengthening - per tooth 238 $504.33 $593.33
Osseous Graft- per tooth or implant 243 $501.97 $590.56
Oral Surgery
Removal of a tooth or part(s) thereof 311 $213.49 $230.87
Sectional removal of tooth or part(s) thereof 314 $281.35 $287.20
Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division 322 $316.52 $331.37
Surgical removal of a tooth or tooth fragment requiring removal of bone 323 $381.13 $407.58
Splinting of displaced tooth/teeth - per tooth 386 $209.88 $262.76
Replantation and splinting of a tooth - per tooth 387 $421.95 $485.24
Endodontics
(These fees include the cost of x-rays where required)    
Direct Pulp Capping 411 $56.84 $59.65
Pulpotomy 414 $140.23 $191.61
Complete chemo-mechanical preparation of root canal - one canal 415 $327.89 $377.06
Complete chemo-mechanical preparation of root canal - each additional canal 416 $161.39 $187.02
Root canal obturation - one canal 417 $321.81 $370.07
Root canal obturation - each additional canal 418 $158.75 $182.55
Extirpation of pulp or debridement of root canal(s) - emergency or palliative 419 $225.18 $225.18
Removal Of Root Filling - Per Canal 451 $153.50 $176.54
Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth 455 $169.97 $195.46
Restorative Services   
Metallic Restoration - One Surface - direct 511 $167.69 $192.84
Metallic Restoration - Two Surfaces - direct 512 $200.41 $230.47
Metallic Restoration - Three Surfaces - direct 513 $234.65 $269.86
Metallic Restoration - Four Surfaces - direct 514 $269.17 $309.55
Metallic Restoration - Five Surfaces - direct 515 $305.67 $351.51
Adhesive Restoration - One Surface - Anterior Tooth - direct 521 $180.30 $207.34
Adhesive Restoration - Two Surfaces - Anterior tooth - direct 522 $212.05 $243.88
Adhesive Restoration - Three Surfaces - Anterior tooth - direct 523 $248.85 $286.18
Adhesive Restoration - Four Surfaces - Anterior tooth - direct 524 $279.98 $321.99
Adhesive Restoration - Five Surfaces - Anterior tooth - direct 525 $329.33 $378.72
Adhesive Restoration - Veneer - Anterior tooth- direct 526 $371.09 $407.54
Adhesive restoration - one surface - posterior tooth - direct 531 $190.09 $218.60
Adhesive restoration - two surfaces - posterior tooth - direct 532 $226.44 $260.41
Adhesive restoration - three surfaces - posterior tooth - direct 533 $264.85 $304.58
Adhesive restoration - four surfaces - posterior tooth - direct 534 $298.36 $343.12
Adhesive restoration - five surfaces - posterior tooth - direct 535 $355.52 $408.85
Adhesive Restoration - Veneer - Posterior tooth - direct 536 $364.30 $407.54
Tooth coloured restoration - one surface - indirect 551 $917.77 $1,055.45
Tooth coloured restoration - two surfaces - indirect 552 $1,017.23 $1,169.82
Tooth coloured restoration - three surfaces - indirect 553 $1,175.06 $1,351.32
Tooth coloured restoration - four surfaces - indirect 554 $1,275.59 $1,466.93
Tooth coloured restoration - five surfaces - indirect 555 $1,398.83 $1,608.65
Tooth - coloured restoration - Veneer - indirect 556 $1,342.62 $1,544.01
Provisional (intermediate/temporary) restoration - per tooth 572 $98.38 $98.38
Pin retention - per pin 575 $44.46 $44.46
Post - Direct 597 $182.27 $204.96
Crown and Bridgework
(If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC)
Full crown - non metallic - indirect 613 $1,580.01 $1,817.02
Full crown - veneered - indirect 615 $1,558.60 $1,792.39
Full crown - metallic indirect 618 $1,568.33 $1,803.57
Post and core for crown - indirect 625 $493.41 $593.33
Preliminary restoration for crown - direct 627 $275.81 $293.07
Provisional bridge pontic - per pontic 632 $312.59 $312.59
Bridge pontic - direct - per pontic 642 $406.98 $468.03
Bridge pontic - indirect - per pontic 643 $1,175.35 $1,586.72
Retainer for bonded fixture - indirect - per tooth 649 $698.23 $802.96
Implant Procedures
Fitting of an implant abutment - per abutment 661 $1,008.01 $1,008.01
Prosthesis with metal frame attached to implants - fixed - per arch 666 $3,632.20 $5,321.85
Removal and reattachment of prosthesis fixed to implant(s) – per implant 669 $175.01 $175.01
Full crown attached to osseointegrated implant - veneered indirect 672 $2,009.60 $2,638.08
Surgical implant guide 679 $238.83 $238.73
Insertion of first stage of two-stage endosseous implant - per implant 684 $2,162.02 $2,162.02
Insertion of one stage endosseous implant - per implant
Includes the cost of hardware
688 $2,609.02 $2,609.02
Second stage surgery of two stage endosseous implant - per implant
Includes the cost of hardware
691 $446.88 $446.88
Prosthodontics
Complete Maxillary Denture 711 $1,448.71 $1,666.01
Complete Mandibular Denture 712 $1,448.71 $1,666.01
Complete Maxillary and Mandibular Denture 719 $2,627.03 $3,021.08
Partial maxillary denture - resin base 721 $930.21 $930.21
Partial mandibular denture - resin base 722 $930.21 $930.21
Partial maxillary denture - cast metal framework including rests and retainers 727 $1,613.95 $1,856.05
Partial mandibular denture - cast metal framework including rests and retainers 728 $1,613.95 $1,856.05
Additional items for Acrylic Dentures only
Retainer - Per Tooth 731 $58.29 $58.29
Occlusal Rest - per rest 732 $16.90 $16.90
Tooth/teeth partial denture 733 $57.30 $57.30
Immediate tooth replacement - per tooth 736 $11.37 $11.37
Relining - complete denture - processed 743 $456.19 $456.19
Relining - partial denture - processed 744 $444.04 $444.04
Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth 768 $197.72 $229.75
Splint  - Resin - Indirect772$298.13$421.95
Orthodontics
Active removable appliance therapy - per arch 821 $1,043.27 $1,196.27
Full arch banding - per arch 831 $2,876.57 $4,111.68
Minor tooth guidance - fixed 846 $932.86 $932.86
Complete course of orthodontic treatment 881 $5,942.32 $7,694.50
General
Travel to provide services 916 FBN* FBN*
Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period 963 $98.38 $137.67
Occlusal splint 965 $654.76 $671.14
Adjustment of pre-existing occlusal splint - per appointment 966 $93.26 $119.29
For dental services provided between 1 July 2021 and 30 June 2022
GeneralSpecialist
Service DescriptionADA NumberMaximum
Payment
Rate
Maximum
Payment
Rate
Diagnostic services
Comprehensive Oral Examination 011 $100.59 $100.59
Periodic Oral Examination 012 $63.58 $63.58
Consultation 014 $100.59 $100.59
Written report (not elsewhere included) 018 $139.95 $184.22
Intraoral periapical or bitewing radiograph - per exposure 022 $49.55 $49.55
Cone Beam Volumetric Tomography - scan acquisition - per appointment 026 $158.16 $158.16
Cephalometric Radiograph - per exposure 036 $111.81 $111.81
Panoramic radiograph - per exposure 037 $111.81 $111.81
Pulp Testing - per appointment 061 $35.96 $35.96
Diagnostic model - per model 071 $69.58 $69.58
Photographic records - intraoral - per appointment 072 $39.73 $39.73
Cone Beam Volumetric Tomography analysis and/or interpretation - maxillary or mandibular dentition (both arches) 089 $73.81 $73.81
Preventive Services
(Prior approval from TAC required for these services)
Removal Of Calculus - first appointment 114 $124.97      $124.97
Bleaching, Internal - per tooth 117 $221.74 $221.74
Topical application of remineralisation and/or cariostatic agents - one treatment 121 $45.60 $45.60
Oral hygiene instruction 141 $49.84 $49.84
Desensitising Procedure - per appointment 165 $46.94 $46.94
Odontoplasty - per tooth 171 $50.22 $50.22
Periodontal Debridement - per tooth 222 $56.94  $65.47     
Periodontal Flap Surgery - per tooth - Limit of 10 per visit, 20 per 12 month period 232 $281.18    $281.18     
Surgical treatment of Peri-implant Disease - per implant 233 $339.25 $339.25
Gingival Graft - per tooth, implant or extraction 235 $489.58 $575.99
Guided Tissue Regeneration - per tooth or implant 236 $489.58 $575.99   
Guided Tissue Regeneration - membrane removal 237 $568.74     $669.12
Periodontal Surgery for Crown Lengthening - per tooth 238 $491.89 $578.69
Osseous Graft- per tooth or implant 243 $489.58 $575.99
Oral Surgery
Removal of a tooth or part(s) thereof 311 $208.22 $225.17
Sectional removal of tooth or part(s) thereof 314 $274.41 $280.11
Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division 322 $308.71 $323.19
Surgical removal of a tooth or tooth fragment requiring removal of bone 323 $371.73 $397.52
Splinting of displaced tooth/teeth - per tooth 386 $204.70 $256.28
Replantation and splinting of a tooth - per tooth 387 $411.54 $473.27
Endodontics
(These fees include the cost of x-rays where required)    
Direct Pulp Capping 411 $55.44 $58.18
Pulpotomy 414 $136.77 $186.88
Complete chemo-mechanical preparation of root canal - one canal 415 $319.80 $367.76
Complete chemo-mechanical preparation of root canal - each additional canal 416 $157.41 $182.41
Root canal obturation - one canal 417 $313.87 $360.94
Root canal obturation - each additional canal 418 $154.83 $178.05
Extirpation of pulp or debridement of root canal(s) - emergency or palliative 419 $219.62 $219.62
Removal Of Root Filling - Per Canal 451 $149.71 $172.18
Additional Visit For Irrigation And/Or Dressing Of The Root Canal System - per tooth 455 $165.78 $190.64
Restorative Services   
Metallic Restoration - One Surface - direct 511 $163.55 $188.08
Metallic Restoration - Two Surfaces - direct 512 $195.46 $224.78
Metallic Restoration - Three Surfaces - direct 513 $228.86 $263.20
Metallic Restoration - Four Surfaces - direct 514 $262.53 $301.91
Metallic Restoration - Five Surfaces - direct 515 $298.13 $342.84
Adhesive Restoration - One Surface - Anterior Tooth - direct 521 $175.85 $202.22
Adhesive Restoration - Two Surfaces - Anterior tooth - direct 522 $206.82 $237.86
Adhesive Restoration - Three Surfaces - Anterior tooth - direct 523 $242.71 $279.12
Adhesive Restoration - Four Surfaces - Anterior tooth - direct 524 $273.07 $314.04
Adhesive Restoration - Five Surfaces - Anterior tooth - direct 525 $321.20 $369.37
Adhesive Restoration - Veneer - Anterior tooth- direct 526 $361.93 $397.48
Adhesive restoration - one surface - posterior tooth - direct 531 $185.40 $213.21
Adhesive restoration - two surfaces - posterior tooth - direct 532 $220.85 $253.98
Adhesive restoration - three surfaces - posterior tooth - direct 533 $258.31 $297.06
Adhesive restoration - four surfaces - posterior tooth - direct 534 $291.00 $334.65
Adhesive restoration - five surfaces - posterior tooth - direct 535 $346.75 $398.76
Adhesive Restoration - Veneer - Posterior tooth - direct 536 $355.31 $397.48
Tooth coloured restoration - one surface - indirect 551 $895.12 $1,029.41
Tooth coloured restoration - two surfaces - indirect 552 $992.13 $1,140.95
Tooth coloured restoration - three surfaces - indirect 553 $1,146.06 $1,317.98
Tooth coloured restoration - four surfaces - indirect 554 $1,244.11 $1,430.73
Tooth coloured restoration - five surfaces - indirect 555 $1,364.31 $1,568.96
Tooth - coloured restoration - Veneer - indirect 556 $1,309.49 $1,505.91
Provisional (intermediate/temporary) restoration - per tooth 572 $95.95 $95.95
Pin retention - per pin 575 $43.36 $43.36
Post - Direct 597 $177.77      $199.90
Crown and Bridgework
(If these procedures are to be carried out in a hospital under general anaesthesia, prior approval must be obtained from the TAC)
Full crown - non metallic - indirect 613 $1,541.02 $1,772.18
Full crown - veneered - indirect 615 $1,520.14 $1,748.16
Full crown - metallic indirect 618 $1,529.63 $1,759.07
Post and core for crown - indirect 625 $481.23 $578.69
Preliminary restoration for crown - direct 627 $269.00 $285.84
Provisional bridge pontic - per pontic 632 $304.88 $304.88
Bridge pontic - direct - per pontic 642 $396.94 $456.48
Bridge pontic - indirect - per pontic 643 $1,146.35 $1,547.57
Retainer for bonded fixture - indirect - per tooth 649 $681.00 $783.15
Implant Procedures
Fitting of an implant abutment - per abutment 661 $983.14 $983.14
Prosthesis with metal frame attached to implants - fixed - per arch 666 $3,542.57 $5,190.53
Removal and reattachment of prosthesis fixed to implant(s) – per implant 669 $170.69 $170.69
Full crown attached to osseointegrated implant - veneered indirect 672 $1,960.01 $2,572.98
Surgical implant guide 679 $232.84 $232.84
Insertion of first stage of two-stage endosseous implant - per implant 684 $2,108.67 $2,108.67
Insertion of one stage endosseous implant - per implant
Includes the cost of hardware
688 $2,544.64 $2,544.64
Second stage surgery of two stage endosseous implant - per implant
Includes the cost of hardware
691 $435.85 $435.85
Prosthodontics
Complete Maxillary Denture 711 $1,412.96 $1,624.90
Complete Mandibular Denture 712 $1,412.96 $1,624.90
Complete Maxillary and Mandibular Denture 719 $2,562.21 $2,946.53
Partial maxillary denture - resin base 721 $907.26 $907.26
Partial mandibular denture - resin base 722 $907.26 $907.26
Partial maxillary denture - cast metal framework including rests and retainers 727 $1,574.12 $1,810.25
Partial mandibular denture - cast metal framework including rests and retainers 728 $1,574.12 $1,810.25
Additional items for Acrylic Dentures only
Retainer - Per Tooth 731 $56.85 $56.85
Occlusal Rest - per rest 732 $16.48 $16.48
Tooth/teeth partial denture 733 $55.89 $55.89
Immediate tooth replacement - per tooth 736 $11.09 $11.09
Relining - complete denture - processed 743 $444.93 $444.93
Relining - partial denture - processed 744 $433.08 $433.08
Adding tooth to partial denture to replace an extracted or decoronated tooth - per tooth 768 $192.84 $224.08
Orthodontics
Active removable appliance therapy - per arch 821 $1,017.53 $1,166.75
Full arch banding - per arch 831 $2,805.59 $4,010.22
Minor tooth guidance - fixed 846 $909.84 $909.84
Complete course of orthodontic treatment 881 $5,795.69 $7,504.63
General
Travel to provide services 916 FBN* FBN*
Clinical occlusal analysis, including muscle and joint palpation - limit one per three year period 963 $95.95 $134.27
Occlusal splint 965 $638.60 $654.58
Adjustment of pre-existing occlusal splint - per appointment 966 $90.96 $116.35

* Note: Where the terminology FBN appears in this schedule, the fee must be negotiated with the TAC before any dental treatment is commenced.