medshield 2019 dental tariffs - specialists ......trf code tariffdescription *pre-authorisation...

*

-

Trf

CodeTariffDescription

*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8025 HANDLING FEE - DIRECT MATERIALS (26% OF MATERIAL COST TO A

MAXIMUM OF R26.00) R 40.20 R 40.20 R 40.20 - R 40.20

8101 ORAL EXAMINATION R 223.70 R 223.70 R 223.70 - R 223.70

8102 COMPREHENSIVE ORAL EXAMINATION R 361.40 R 361.40 R 361.40 - R 361.40

8104 LIMITED ORAL EXAMINATION R 108.50 R 108.50 R 108.50 - R 108.50

8106 SPECIAL REPORT R 229.70 R 229.70 R 229.70 - R 229.70

8107 INTRAORAL RADIOGRAPH - PERIAPICAL R 90.60 R 90.60 R 90.60 - R 90.60

8108 INTRAORAL RADIOGRAPHS - COMPLETE SERIES R 701.00 R 701.00 R 701.00 - R 701.00

8109 INFECTION CONTROL/BARRIER TECHNIQUES R 20.10 R 20.10 R 20.10 - R 20.10

8110 STERILIZED INSTRUMENTATION R 52.00 R 52.00 R 52.00 - R 52.00

8112 INTRAORAL RADIOGRAPH - BITEWING R 90.60 R 90.60 R 90.60 - R 90.60

8113 INTRAORAL RADIOGRAPH - OCCLUSAL R 156.00 R 156.00 R 156.00 - R 156.00

8114 EXTRAORAL RADIOGRAPH - HAND-WRIST R 362.00 R 362.00 R 362.00 - R 362.00

8115 EXTRAORAL RADIOGRAPH - PANORAMIC R 362.00 R 362.00 R 362.00 - R 362.00

8116 EXTRAORAL RADIOGRAPH - CEPHALOMETRIC R 362.00 R 362.00 R 362.00 - R 362.00

8117 DIAGNOSTIC MODELS R 97.30 R 97.30 R 97.30 - R 97.30

8118 EXTRAORAL RADIOGRAPH - SKULL/FACIAL BONE R 362.00 R 362.00 R 362.00 - R 362.00

8119 DIAGNOSTIC MODELS MOUNTED R 244.70 R 244.70 R 244.70 - R 244.70

8120 TREATMENT PLAN COMPLETED - - - - -

8121 ORAL AND/OR FACIAL IMAGE (DIGITAL/CONVENTIONAL)R 97.30 R 97.30 R 97.30 - R 97.30

8123 CARIES SUSCEPTIBILITY TESTS (BY ARRANGEMENT) - - - - -

8124 PULP TESTS - - - - -

Denis shall be entitled to update the tariff schedule from time to time.

The tariffs listed do not consider scheme exclusions and scope of practice and is by no means a commitment of funding.

Benefit entitlement is governed by the relevant scheme option and rules as well as risk management interventions and protocols.

If the clinical code requires managed care intervention, all associated lab codes will be included in the authorisation process.

Pre-authorisation is required for the dental code to attract benefit

Tariff amount not applicable

MEDSHIELD 2019 DENTAL TARIFFS - SPECIALISTS & DENTAL TECHNICIANS

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*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8129 OFFICE/HOSPITAL VISIT – AFTER REGULARLY SCHEDULED HOURSR 337.00 - R 337.00 - R 337.00

8131 EMERGENCY DENTAL TREATMENT R 137.40 R 137.40 R 137.40 - R 280.00

8132 PULP REMOVAL (PULPECTOMY) R 224.70 - - - R 298.80

8133 RECEMENT INLAY, ONLAY, CROWN OR VENEER R 137.40 - - - R 174.30

8135 REMOVE INLAY, ONLAY OR CROWN R 273.30 - - - R 273.30

8136 ACCESS THROUGH A PROSTHETIC CROWN OR INLAY TO FACILITATE

ROOT CANAL TREATMENT R 122.30 - R 122.30 - R 122.30

8137 EMERGENCY CROWN (CHAIR-SIDE) R 471.10 - - - R 471.10

8138 REMOVE RETENTION POST (PREFABRICATED OR CAST) R 179.40 - - - R 179.40

8139 APPOINTMENT NOT KEPT /30MIN - - - - -

8140 HOUSE/EXTENDED CARE FACILITY/HOSPITAL CALL * R 223.00 - R 223.00 - R 223.00

8141 INHALATION SEDATION - FIRST 15 MINUTES OR PART THEREOFR 100.70 - R 100.70 - R 100.70

8143 INHALATION SEDATION - EACH ADDNL 15 MINUTES R 52.00 - R 52.00 - R 52.00

8144 INTRAVENOUS SEDATION * R 60.30 - R 60.30 - R 60.30

8145 LOCAL ANAESTHETIC - PER VISIT R 87.30 R 87.30 R 87.30 - R 87.30

8146 RESIN BONDING FOR RESTORATIONS - - - - -

8147 MONITORING EQUIPMENT FOR INTRAVENOUS SEDATIONR 214.70 - R 214.70 - R 214.70

8151 ORAL HYGIENE INSTRUCTION - - R 275.00 - R 275.00

8153 ORAL HYGIENE INSTRUCTION - EACH ADDITIONAL VISIT - - R 132.40 - R 132.40

8154 ORAL EXAMINATION - ORAL HYGIENIST - - - - -

8155 POLISHING - COMPLETE DENTITION R 137.40 - R 189.40 - R 137.40

8157 RE-BURNISHING AND POLISHING OF RESTORATIONS - COMPLETE

DENTITION - - - - -

8158 ENAMEL MICROABRASION - - - - -

8159 PROPHYLAXIS - COMPLETE DENTITION R 270.00 - R 380.70 - R 270.00

8160 REMOVAL OF GROSS CALCULUS - - - - -

8161 TOPICAL APPLICATION OF FLUORIDE - CHILD R 137.40 - R 137.40 - R 137.40

8162 TOPICAL APPLICATION OF FLUORIDE - ADULT - - R 137.40 - R 137.40

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8163 DENTAL SEALANT R 90.60 - R 90.60 - R 90.60

8164 LIMITED ORAL EXAMINATION - ORAL HYGIENIST - - - - -

8165 SEDATIVE FILLING R 137.40 - R 137.40 - R 137.40

8166 APPLICATION OF DESENSITISING RESIN, PER TOOTH R 90.60 - R 90.60 - R 90.60

8167 APPLICATION OF DESENSITISING MEDICAMENT, PER VISITR 105.70 - R 105.70 - R 105.70

8169 OCCLUSAL GUARD R 528.10 R 528.10 R 528.10 - R 528.10

8171 MOUTH PROTECTOR R 159.80 R 159.80 R 159.80 - R 159.80

8172 COST OF ORTHOTIC APPLIANCE * * * * - *

8173 SPACE MAINTAINER - FIXED, PER ABUTMENT R 255.00 R 255.00 R 255.00 - R 255.00

8175 SPACE MAINTAINER - REMOVABLE R 328.70 R 328.70 R 328.70 - R 328.70

8176 PERIODONTAL SCREENING R 177.80 - R 188.50 - R 188.50

8177 ORAL HYGIENE INSTRUCTION (PERIODONTALLY COMPROMISED

PATIENT) - - - - -

8178 ORAL HYGIENE INSTRUCTION - EACH ADDITIONAL VISIT

(PERIODONTALLY COMPROMISED PATIENT) - - - - -

8179 POLISHING - COMPLETE DENTITION (PERIODONTALLY COMPROMISED

PATIENT) R 157.70 - R 157.70 - R 157.70

8180 PROPHYLAXIS - COMPLETE DENTITION (PERIODONTALLY

COMPROMISED PATIENT) * R 293.40 - R 293.40 - -

8183 THERAPEUTIC DRUG INJECTION - - - - -

8189 RE-EXAMINATION - EXISTING CONDITION - - - - -

8190 CONSULTATION - SECOND OPINION OR ADVICE R 223.70 R 223.70 R 223.70 - R 223.70

8192 SUTURE - MINOR R 677.40 - R 677.40 - R 677.40

8201 EXTRACTION - TOOTH OR EXPOSED TOOTH ROOTS (FIRST PER

QUADRANT) R 206.10 R 137.40 R 137.40 - R 137.40

8202 EXTRACTION - EACH ADDITIONAL TOOTH OR EXPOSED TOOTH ROOTSR 83.00 R 55.30 R 55.30 - R 55.30

8213 SURGICAL REMOVAL OF RESIDUAL ROOTS, FIRST TOOTH PER

QUADRANT R 593.60 - R 593.60 - R 593.60

8214 SURGICAL REMOVAL OF RESIDUAL ROOTS, SECOND AND

SUBSEQUENT TEETH''S ROOTS R 457.70 - R 457.70 - R 457.70

8220 COST OF SUTURE MATERIAL R 215.30 - R 215.30 - R 215.30

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8228 ART RESTORATIONS - - - - -

8231 COMPLETE DENTURES - MAXILLARY AND MANDIBULAR - - R 2 216.60 - R 4 627.70

8232 COMPLETE DENTURE - MAXILLARY OR MANDIBULAR - - R 1 366.50 - R 3 237.70

8233 PARTIAL DENTURE - RESIN BASE - ONE TOOTH - - R 635.40 - R 635.40

8234 PARTIAL DENTURE - RESIN BASE - TWO TEETH - - R 635.40 - R 635.40

8235 PARTIAL DENTURE - RESIN BASE - THREE TEETH - - R 950.70 - R 950.70

8236 PARTIAL DENTURE - RESIN BASE - FOUR TEETH - - R 950.70 - R 950.70

8237 PARTIAL DENTURE - RESIN BASE - FIVE TEETH - - R 950.70 - R 950.70

8238 PARTIAL DENTURE - RESIN BASE - SIX TEETH - - R 1 261.00 - R 1 261.00

8239 PARTIAL DENTURE - RESIN BASE - SEVEN TEETH - - R 1 261.00 - R 1 261.00

8240 PARTIAL DENTURE - RESIN BASE - EIGHT TEETH - - R 1 261.00 - R 1 261.00

8241 PARTIAL DENTURE - RESIN BASE - NINE OR MORE TEETH - - R 1 261.00 - R 1 261.00

8244 IMMEDIATE DENTURE - MAXILLARY - - R 1 366.50 - R 2 049.80

8245 IMMEDIATE DENTURE - MANDIBULAR - - R 1 366.50 - R 2 049.80

8251 CLASP OR REST - CAST GOLD - - - - -

8253 CLASP OR REST - WROUGHT GOLD - - - - -

8255 CLASP OR REST - STAINLESS STEEL - - - - -

8257 BAR - LINGUAL OR PALATAL - - - - -

8259 REBASE COMPLETE OR PARTIAL DENTURE (LABORATORY) - - R 518.00 - R 747.70

8261 REMODEL COMPLETE OR PARTIAL DENTURE - - R 831.70 - R 831.70

8263 RELINE COMPLETE OR PARTIAL DENTURE (CHAIR-SIDE) - - R 328.70 - R 410.70

8265 TISSUES CONDITIONING PER ARCH (INCLUDING SOFT SELF-CURE

RELINE) R 214.70 - R 214.70 - R 275.00

8267 RELINE COMPLETE OR PARTIAL DENTURE (LABORATORY) - - R 756.30 - R 756.30

8269 REPAIR DENTURE OR OTHER INTRA-ORAL APPLIANCE - - - - R 187.70

8270 ADD CLASP TO EXISTING PARTIAL DENTURE - - - - -

8271 ADD TOOTH TO EXISTING PARTIAL DENTURE - - - - -

8273 IMPRESSION TO REPAIR OR MODIFY A DENTURE OR OTHER INTRA-

ORAL APPLIANCE - - R 100.70 - R 100.70

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8275 ADJUST COMPLETE OR PARTIAL DENTURE - - R 100.70 - R 100.70

8277 INLAY IN DENTURE - - - - R 823.20

8281 PARTIAL DENTURE - CAST METAL FRAMEWORK ONLY - - R 1 482.30 - R 1 482.30

8301 PULP CAP - DIRECT - - - - -

8303 PULP CAP - INDIRECT - - - - -

8304 RUBBER DAM PER ARCH R 107.30 - R 107.30 - R 107.30

8306 COST OF MTA - - - - -

8307 PULP AMPUTATION (PULPOTOMY) R 179.40 - R 179.40 - R 179.40

8310 SUPPLY OF BLEACHING MATERIALS - - - - -

8325 INTERNAL BLEACHING - PER TOOTH - - - - R 488.00

8327 INTERNAL BLEACHING - EACH ADDITIONAL VISIT - - - - R 234.00

8328 ROOT CANAL OBTURATION - ANTERIORS AND PREMOLARS - EACH

ADDITIONAL CANAL R 255.00 - - - R 339.10

8329 ROOT CANAL THERAPY - ANTERIORS AND PREMOLARS - EACH

ADDITIONAL CANAL R 318.60 - - - R 423.70

8330 REMOVAL OF ROOT CANAL OBSTRUCTION R 179.40 - R 179.40 - R 179.40

8332 ROOT CANAL PREPARATORY VISIT - SINGLE CANAL TOOTHR 137.40 - - - R 182.60

8333 ROOT CANAL PREPARATORY VISIT - MULTI CANAL TOOTHR 192.70 - - - R 192.70

8334 RE-TREATMENT OF PREVIOUSLY COMPLETED ROOT CANAL THERAPY,

PER CANAL R 203.00 - R 203.00 - R 244.70

8335 ROOT CANAL OBTURATION - ANTERIORS AND PREMOLARS - FIRST

CANAL R 623.70 - - - -

8336 ROOT CANAL OBTURATION - POSTERIORS - FIRST CANALR 858.40 - - - -

8337 ROOT CANAL OBTURATION - POSTERIORS - EACH ADDITIONAL CANALR 255.00 - - - -

8338 ROOT CANAL THERAPY - ANTERIORS AND PREMOLARS - FIRST CANALR 954.00 - - - -

8339 ROOT CANAL THERAPY - POSTERIORS - FIRST CANAL R 1 311.10 - - - -

8340 ROOT CANAL THERAPY - POSTERIORS - EACH ADDITIONAL CANALR 318.60 - - - -

8341 AMALGAM - ONE SURFACE R 273.30 - R 273.30 - R 273.30

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8342 AMALGAM - TWO SURFACES R 337.00 - R 337.00 - R 337.00

8343 AMALGAM - THREE SURFACES R 410.70 - R 410.70 - R 410.70

8344 AMALGAM - FOUR OR MORE SURFACES R 457.70 - R 457.70 - R 457.70

8345 PREFABRICATED POST RETENTION, PER POST (IN ADDITION TO

RESTORATION) R 270.00 - R 270.00 - R 270.00

8347 PIN RETENTION - FIRST PIN (IN ADDITION TO RESTORATION)R 135.70 - R 135.70 - R 135.70

8348 PIN RETENTION - EACH ADDITIONAL PIN (IN ADDITION TO

RESTORATION) R 125.70 - R 125.70 - R 125.70

8349 CARVE RESTORATION TO ACCOMMODATE EXISTING REMOVABLE

PROSTHESIS - - - - -

8350 RESIN CROWN - ANTERIOR PRIMARY TOOTH (DIRECT) R 596.30 - R 596.30 - R 596.30

8351 RESIN - ONE SURFACE, ANTERIOR R 300.00 - R 300.00 - R 300.00

8352 RESIN - TWO SURFACES, ANTERIOR R 377.30 - R 377.30 - R 377.30

8353 RESIN - THREE SURFACES, ANTERIOR R 451.00 - R 451.00 - R 451.00

8354 RESIN - FOUR OR MORE SURFACES, ANTERIOR R 503.00 - R 503.00 - R 503.00

8355 VENEER - RESIN (CHAIR-SIDE) R 476.30 - R 476.30 - R 476.30

8357 PREFABRICATED METAL CROWN R 280.00 - R 280.00 - R 280.00

8361 INLAY - METAL - ONE SURFACE - - - - R 823.30

8362 INLAY/ONLAY - METAL - TWO SURFACES - - - - R 1 193.70

8363 INLAY/ONLAY - METAL - THREE SURFACES - - - - R 1 851.00

8364 INLAY/ONLAY - METAL - FOUR OR MORE SURFACES - - - - R 1 851.00

8366 PIN RETENTION AS PART OF CAST RESTORATION (ANY NUMBER OF

PINS) - - - - R 275.00

8367 RESIN - ONE SURFACE, POSTERIOR R 325.30 - R 325.30 - R 325.30

8368 RESIN - TWO SURFACES, POSTERIOR R 402.40 - R 402.40 - R 402.40

8369 RESIN - THREE SURFACES, POSTERIOR R 486.30 - R 486.30 - R 486.30

8370 RESIN - FOUR OR MORE SURFACES, POSTERIOR R 523.00 - R 523.00 - R 523.00

8371 INLAY - PORCELAIN - ONE SURFACE - - - - R 994.30

8372 INLAY/ONLAY - PORCELAIN - TWO SURFACES - - - - R 1 432.00

8373 INLAY/ONLAY - PORCELAIN - THREE SURFACES - - - - R 2 225.00

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8374 INLAY/ONLAY - PORCELAIN - FOUR OR MORE SURFACES - - - - R 2 225.00

8375 PREFABRICATED RESIN CROWN R 280.00 - R 280.00 - R 280.00

8376 CORE BUILD-UP WITH PREFABRICATED POSTS - - - - R 747.70

8379 COST OF PREFABRICATED POSTS - - - - R 104.10

8381 INLAY - RESIN - ONE SURFACE - - - - R 994.30

8382 INLAY/ONLAY - RESIN - TWO SURFACES - - - - R 1 432.00

8383 INLAY/ONLAY - RESIN - THREE SURFACES - - - - R 2 225.00

8384 INLAY/ONLAY - RESIN - FOUR OR MORE SURFACES - - - - R 2 225.00

8391 CAST CORE WITH SINGLE POST * - - - - R 315.30

8392 CAST POST (EACH ADDITIONAL) - - - - R 187.70

8397 CAST CORE WITH PINS (ANY NUMBER OF PINS) * - - - - R 654.00

8398 CORE BUILD-UP WITH PINS - - - - R 610.30

8401 CROWN - FULL CAST METAL * - - - - R 2 310.40

8403 CROWN - 3/4 CAST METAL * - - - - R 2 310.40

8404 CROWN - 3/4 PORCELAIN/CERAMIC * - - - - R 2 225.00

8405 CROWN - RESIN LABORATORY * - - - - R 2 225.00

8407 CROWN - RESIN WITH METAL * - - - - R 2 310.40

8409 CROWN - PORCELAIN/CERAMIC * - - - - R 2 310.40

8410 PROVISIONAL CROWN - - R 305.00 - R 457.70

8411 CROWN - PORCELAIN VENEERED TO METAL * - - - - R 2 310.40

8413 REPAIR CROWN (PERMANENT OR PROVISIONAL) R 305.00 - - - R 305.00

8414 ADDITIONAL FEE FOR PROVISION OF CROWN WITHIN AN EXISTING

CLASP OR REST - - - - R 90.60

8415 PONTIC - CERAMIC * - - - - R 1 280.90

8416 PONTIC - CAST METAL * - - - - R 1 017.80

8417 PONTIC - RESIN WITH METAL * - - - - R 1 280.90

8418 PONTIC - PORCELAIN VENEERED TO METAL * - - - - R 1 280.90

8419 PROVISIONAL PONTIC - - - - R 457.70

8432 INLAY/ONLAY RETAINER - METAL - TWO SURFACES * - - - - R 1 193.70

8433 INLAY/ONLAY RETAINER - METAL - THREE SURFACES * - - - - R 1 851.00

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8434 INLAY/ONLAY RETAINER - METAL - FOUR OR MORE SURFACES* - - - - R 1 851.00

8436 INLAY/ONLAY RETAINER - PORCELAIN - TWO SURFACES * - - - - R 1 432.00

8437 INLAY/ONLAY RETAINER - PORCELAIN - THREE SURFACES* - - - - R 2 225.00

8438 INLAY/ONLAY RETAINER - PORCELAIN - FOUR OR MORE SURFACES* - - - - R 2 225.00

8441 CROWN RETAINER - FULL CAST METAL * - - - - R 2 310.40

8442 CROWN RETAINER - 3/4 CAST METAL * - - - - R 2 310.40

8443 CROWN RETAINER - CERAMIC * - - - - R 2 310.40

8444 CROWN RETAINER - 3/4 CERAMIC * - - - - R 2 310.40

8445 CROWN RETAINER - PORCELAIN VENEERED TO METAL * - - - - R 2 310.40

8446 CROWN RETAINER - RESIN WITH METAL * - - - - R 2 310.40

8447 PROVISIONAL CROWN RETAINER - - - - R 457.70

8499 GENERAL ANAESTHETIC - - - - -

8501 CONSULTATION - PROSTHODONTIS - - - - -

8503 OCCLUSION ANALYSIS MOUNTED - - - - R 457.70

8505 PANTOGRAPHIC RECORDING - - - - R 664.00

8506 DETAILED CONSULTATION - PROSTHODONTIST - - - - -

8507 COMPREHENSIVE CONSULTATION - PROSTHODONTIST - - - - -

8508 ELECTROGNATHOGRAPHIC RECORDING - - - - R 711.00

8509 ELECTROGNATHOGRAPHIC RECORDING WITH COMPUTER ANALYSIS - - - - R 1 180.40

8514 RECEMENT BRIDGE R 137.40 - - - R 174.30

8516 REMOVE BRIDGE R 273.30 - - - R 273.30

8517 REIMPLANTATION OF AVULSED TOOTH (INCLUDE STABILISATION)R 317.40 - R 317.40 - R 476.30

8518 REPAIR BRIDGE R 305.00 - - - R 305.00

8533 IMPLANT SUPPORTED REMOVABLE COMPLETE OVERDENTURE - - - - R 3 695.40

8534 IMPLANT SUPPORTED REMOVABLE PARTIAL OVERDENTURE - - - - R 2 956.30

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8536 CROWN-IMPLANT/ABUTMENT SUPPORTED CROWN -

PORCELAIN/CERAMIC * - - - - R 2 694.40

8537 CROWN-IMPLANT/ABUTMENT SUPPORTED CROWN - PORCELAIN

WITH METAL * - - - - R 2 694.40

8538 CROWN-IMPLANT/ABUTMENT SUPPORTED CROWN - CAST METAL* - - - - R 2 694.40

8546 IMPLANT SUPPORTED CROWN RETAINER - CERAMIC * - - - - R 2 694.40

8547 IMPLANT SUPPORTED CROWN RETAINER - PORCELAIN VENEERED TO

METAL * - - - - R 2 694.40

8548 CROWN RETAINER - IMPLANT/ABUTMENT SUPPORTED - CAST METAL* - - - - R 2 694.40

8551 OCCLUSAL ADJUSTMENT - MAJOR - R 1 304.40 - - R 1 304.40

8552 VENEER - PORCELAIN (LABORATORY) - - - - R 1 581.10

8553 OCCLUSAL ADJUSTMENT - MINOR R 415.70 R 415.70 R 415.70 - R 415.70

8554 VENEER - RESIN (LABORATORY) - - - - R 1 581.10

8560 COST OF CERAMIC BLOCK * - - - - R 616.40

8561 GOLD FOIL CLASS I OR IV - - - - R 1 193.70

8563 GOLD FOIL CLASS V - - - - R 1 396.70

8565 GOLD FOIL CLASS III - - - - R 1 757.10

8570 FABRICATION OF COMPUTER GENERATED CERAMIC RESTORATION* - - - - R 1 495.40

8578 PREFABRICATED ABUTMENT - - - - R 382.30

8579 CUSTOM ABUTMENT - - - - R 1 743.70

8580 CUSTOMISED PREFABRICATED ABUTMENT * - - - - *

8581 CAST CORE WITH SINGLE POST - - - - -

8582 CAST CORE WITH DOUBLE POST - - - - -

8583 CAST CORE WITH TRIPLE POST - - - - -

8584 CONNECTOR BAR - IMPLANT SUPPORTED - - - - -

8585 CONNECTOR BAR - - - - -

8586 STRESS BREAKER - - - - -

8587 COPING METAL - - - - R 382.30

8590 IMPLANT MAINTENANCE PROCEDURES - PER IMPLANT - - - - R 169.30

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8592 CROWN - IMPLANT/ABUTMENT SUPPORTED * - - - - R 2 694.40

8594 REPAIR OF IMPLANT SUPPORTED PROSTHESIS - - - - R 187.70

8595 REPAIR OF IMPLANT ABUTMENT - - - - R 187.70

8597 LOCKS AND MILLED RESTS - - - - R 187.70

8599 PRECISION ATTACHMENT (REMOVABLE DENTURE) - - - - R 457.70

8600 COST OF IMPLANT COMPONENTS * * - * * *

8611 PONTIC - SANITARY - - - - -

8613 PONTIC - POSTERIOR - - - - -

8615 PONTIC - ANTERIOR/PREMOLAR - - - - -

8617 RETAINER CAST METAL (MARYLAND TYPE RETAINER) * - - - - R 1 193.70

8631 ROOT CANAL THERAPY - FIRST CANAL SPECIALIST PROSTHODONTIST - - - - -

8633 ROOT CANAL THERAPY - EACH ADDITIONAL CANAL SPECIALIST

PROSTHODONTIST - - - - -

8635 APEXIFICATION/APEXOGENESIS/RECALCIFICATION – PER VISITR 182.70 - R 182.70 - R 359.00

8640 REMOVAL OF FRACTURED ROOT CANAL INSTRUMENT - - - - R 476.30

8643 COMPLETE DENTURES - MAXILLARY AND MANDIBULAR. ONLY FOR

PROSTHODONTISTS - - - - -

8645 COMPLETE DENTURES - MAXILLARY OR MANDIBULAR. ONLY FOR

PROSTHODONTISTS - - - - -

8649 IMMEDIATE DENTURE - MAXILLARY. ONLY FOR PROSTHODONTIST - - - - -

8651 IMMEDIATE DENTURE - MANDIBULAR. ONLY FOR PROSTHODONTIST - - - - -

8652 OVERDENTURE - COMPLETE - - - - R 3 695.40

8653 OVERDENTURE - PARTIAL - - - - R 2 956.30

8654 IMPLANT SUPPORTED FIXED-DETACHABLE COMPLETE OVERDENTURE - - - - R 4 156.50

8655 IMPLANT SUPPORTED FIXED-DETACHABLE PARTIAL OVERDENTURE - - - - R 2 848.20

8657 REPLACEMENT OF PRECISION ATTACHMENT - - - - R 187.70

8658 INTERIM COMPLETE DENTURE - - - - R 2 049.70

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

8659 INTERIM PARTIAL DENTURE - - - - R 1 639.70

8660 ADDITIONAL FEE TO IMPLANT SUPPORTED FIXED-DETACHABLE

DENTURE - PER IMPLANT - - - - R 382.30

8661 DIAGNOSTIC DENTURES (INCLUDING TISSUE CONDITIONING) - - - - -

8662 ADJUST COMPLETE OR PARTIAL DENTURES (REMOUNTING) - - - - R 533.30

8663 METAL BASE TO COMPLETE DENTURE - - - - R 1 113.30

8664 REMOUNT CROWN OR BRIDGE FOR ADJUSTMENT - - - - R 557.20

8667 SOFT BASE TO DENTURE (HEAT CURED) - - - - R 1 113.30

8671 PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENTURE

BASE - - - - -

8672 ALTERED CAST TECHNIQUE (IN ADDITION TO PARTIAL DENTURE) - - R 95.20 - R 142.60

8674 ADDITIVE PARTIAL DENTURE - - - - R 1 676.70

8701 CONSULTATION - PERIODONTIST - - - - -

8703 CONSULTATION - PERIODONTIST (DETAILED) - - - - -

8705 RE-EXAMINATION - PERIODONTIST - - - - -

8707 PERIODONTAL SCREENING - PERIODONTIST - - - - -

8723 PROVISIONAL SPLINTING - EXTRACORONAL (WIRE) - PER SEXTANTR 255.00 - R 382.30 - R 382.30

8725 PROVISIONAL SPLINTING - EXTRACORONAL (WIRE PLUS RESIN) - PER

SEXTANT R 369.90 - R 555.00 - R 555.00

8727 PROVISIONAL SPLINTING - INTRACORONAL - PER TOOTHR 116.10 - R 174.30 - R 174.30

8731 INCISION & DRAINAGE OF ABSCESS - INTRA-ORAL * R 219.20 - R 328.70 - *

8737 ROOT PLANING - FOUR OR MORE TEETH PER QUADRANT* - - R 746.00 - R 550.10

8739 ROOT PLANING - ONE TO THREE TEETH PER QUADRANT * - - R 595.30 - R 437.50

8741 GINGIVECTOMY/GINGIVOPLASTY - FOUR OR MORE TEETH PER

QUADRANT - - R 984.30 - -

8743 GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE TEETH PER

QUADRANT - - R 781.30 - -

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8749 FLAP PROCEDURE, ROOT PLANING AND ONE TO THREE SURGICAL

SERVICES - PER QUADRANT - - R 2 235.00 - -

8751 FLAP PROCEDURE, ROOT PLANING AND ONE TO THREE SURGICAL

SERVICES - PER SEXTANT - - R 1 851.00 - -

8753 FLAP PROCEDURE, ROOT PLANING AND FOUR OR MORE SURGICAL

SERVICES - PER QUADRANT - - R 2 770.00 - -

8755 FLAP PROCEDURE, ROOT PLANING AND FOUR OR MORE SURGICAL

SERVICES - PER SEXTANT - - R 2 245.10 - -

8756 CLINICAL CROWN LENGTHENING (ISOLATED PROCEDURE)* - - R 1 361.40 - *

8759 PEDICLE FLAPPED GRAFT (ISOLATED PROCEDURE) - - R 1 022.70 - -

8761 MASTICATORY MUCOSAL AUTOGRAFT - ONE TO FOUR TEETH

(ISOLATED PROCEDURE) R 1 111.70 - R 1 111.70 - -

8762 MASTICATORY MUCOSAL AUTOGRAFT - FOUR OR MORE TEETH

(ISOLATED PROCEDURE) R 1 670.00 - R 1 670.00 - -

8763 WEDGE RESECTION (ISOLATED PROCEDURE) * R 436.00 - R 654.00 - *

8765 HEMISECTION OF A TOOTH, RESECTION OF A ROOT OR TUNNEL

PREPARATION (ISOLATED PROCEDURE) - - R 898.70 - R 898.70

8766 BONE REGENERATION/REPAIR PROCEDURE - AS PART OF A FLAP

OPERATION - - R 535.00 - -

8767 BONE REGENERATION/REPAIR PROCEDURE - AT A SINGLE SITER 1 386.70 - R 1 386.70 - -

8768 UNLISTED PERIODONTAL PROCEDURE - - R 654.00 - -

8769 MEMBRANE REMOVAL (USED FOR GUIDED TISSUE REGENERATION)R 654.00 - R 654.00 - -

8770 COST OF BONE REGENERATIVE/REPAIR MATERIAL * - - - - -

8772 SUBMUCOSAL CONNECTIVE TISSUE AUTOGRAFT (ISOLATED

PROCEDURE) R 1 123.40 - R 1 123.40 - -

8773 COST OF INTRAPOCKET CHEMOTHERAPEUTIC AGENT - - - - -

8781 CONSULTATION - ORAL MEDICINE (SIMPLE) - - - - -

8782 CONSULTATION - ORAL MEDICINE (COMPLEX) - - - - -

8783 CONSULTATION - ORAL MEDICINE (SUBSEQUENT) - - - - -

8787 UNLISTED ORAL MEDICINE PROCEDURE - - R 234.70 - -

8801 CONSULTATION - ORTHODONTIST - - - - -

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8803 CONSULTATION - ORTHODONTIS (SUBSEQUENT, RETENTION AND

POST TREATMENT) - - - - -

8811 TRACING AND ANALYSIS OF EXTRA-ORAL FILM R 42.00 R 42.00 R 42.00 - R 42.00

8837 DIAGNOSIS AND TREATMENT PLANNING - ORTHODONTIST - - - - -

8839 DIAGNOSTIC SETUP R 186.80 R 280.00 - - -

8840 TREATMENT PLANNING FOR ORTHOGNATHIC SURGERY - ALLR 965.70 R 965.70 - - -

8841 ORTHO TX - FIXED LINGUAL APPLIANCE - ONE ARCH * - * - - -

8842 ORTHO TX - FIXED LINGUAL APPLIANCE - ONE ARCH, MODEATE * - * - - -

8843 ORTHO TX - FIXED LINGUAL APPLIANCE - ONE ARCH, SEVERE * - * - - -

8846 REPAIR ORTHODONTIC APPLIANCE - REMOVABLE - R 189.40 - - -

8847 REPLACE ORTHODONTIC APPLIANCE - REMOVABLE - R 654.00 - - -

8848 REPAIR ORTHODONTIC APPLIANCE - FIXED - R 280.00 - - -

8849 RETAINER (ORTHODONTIC) - R 654.00 - - -

8850 TREATMENT OF MPDS - FIRST VISIT R 210.10 R 315.30 R 210.10 - R 315.30

8851 TREATMENT OF MPDS - SUBSEQUENT VISIT R 110.70 R 166.00 R 110.70 - R 166.00

8852 OCCLUSAL ORTHOTIC APPLIANCE R 695.70 R 695.70 R 695.70 - R 695.70

8855 CONSULTATION - CLEFT PALATE THERAPY (HOUSE OR HOSPITAL) - R 382.30 - - R 382.30

8856 CONSULTATION - CLEFT PALATE (SUBSEQUENT) - R 187.70 - - R 187.70

8857 CONSULTATION - CLEFT PALATE (MAXIMUM) - R 1 306.10 - - R 1 306.10

8858 ORTHO TX - FUNCTIONAL APPLIANCE * - * - - -

8861 ORTHO TX - PARTIAL FIXED APPLIANCE - MINOR * - * - - -

8862 ORTHO TX - REMOVABLE APPLIANCE * - * - - -

8863 ORTHO TX - EACH ADDITIONAL REMOVABLE APPLIANCE * - * - - -

8865 ORTHO TX - PARTIAL FIXED APPLIANCE - ONE ARCH * - * - - -

8866 ORTHO TX - PARTIAL FIXED APPLIANCE - BOTH ARCHES * - * - - -

8867 ORTHO TX - FIXED APPLIANCE - ONE ARCH * - * - - -

8868 ORTHO TX - FIXED APPLIANCE - ONE ARCH, MODEATE * - * - - -

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8869 ORTHO TX - FIXED APPLIANCE - ONE ARCH, SEVERE * - * - - -

8873 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 1 MILD * - * - - -

8874 ORTHO TX - FIXED LINGUAL APPLIANCE - BOTH ARCHES, CLASS 1 MILD * - * - - -

8875 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 1 MODERATE * - * - - -

8876 ORTHO TX - FIXED LINGUAL APPLIANCE - BOTH ARCHES, CLASS 1

MODERATE * - * - - -

8877 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 1 SEVERE * - * - - -


SEVERE * - * - - -

8879 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 1 SEVERE W/

COMPLICATIONS * - * - - -


SEVERE W/ COMPLICATIONS * - * - - -

8881 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 2/3 MILD * - * - - -

8882 ORTHO TX - FIXED LINGUAL APPLIANCE - BOTH ARCHES, CLASS 2/3

MILD * - * - - -

8883 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 2/3 MODERATE * - * - - -


MODERATE * - * - - -

8885 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 2/3 SEVERE * - * - - -


SEVERE * - * - - -

8887 ORTHO TX - FIXED APPLIANCE - BOTH ARCHES, CLASS 2/3 SEVERE W/

COMPLICATIONS * - * - - -


SEVERE W/ COMPLICATIONS * - * - - -

8890 MONTHLY INSTALMENT ORTHO TX * - * - - -

8891 ORTHODONTIC TRANSFER * - * - - -

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8892 ORTHODONTIC RE-TREATMENT * - * - - -

8901 CONSULTATION - MFOS R 285.10 - - - -

8902 CONSULTATION - MFOS (DETAILED) R 746.00 - - - -

8903 HOUSE/HOSP/NURSING HOME CONSULTATION - MFOSR 249.70 - - - -

8904 HOUSE/HOSP/NURSING HOME CONSULTATION (SUBSEQUENT) -

MFOS R 166.00 - - - -

8905 AFTER REGULARLY HOURS CONSULTATION - MFOS R 365.60 - - - -

8907 HOUSE/HOSP/NURSING HOME CONSULTATION (MAXIMUM PER

WEEK) - MFOS R 415.70 - - - -

8908 SURGICAL REMOVAL OF ROOTS FROM MAXILLARY ANTRUMR 2 723.00 - - - -

8909 ORAL ANTRAL FISTULA CLOSURE R 2 087.40 - - - -

8911 CALDWELL-LUC PROCEDURE R 816.70 - - - -

8917 BIOPSY OF ORAL TISSUE - SOFT R 462.70 - R 462.70 - -

8919 BIOPSY OF BONE - NEEDLE * R 801.40 - * - -

8921 BIOPSY – EXTRA-ORAL BONE/SOFT TISSUE * R 1 311.10 - * - -

8931 TREATMENT OF POST-EXTRACTION HAEMORRHAGE R 603.70 - R 100.70 - R 100.70

8933 TREATMENT OF HAEMORRHAGE (BLOOD DYSCRACIAS) R 2 087.40 - R 1 391.70 - R 1 391.70

8935 TREATMENT OF SEPTIC SOCKET R 157.70 - R 100.70 - R 100.70

8937 SURGICAL REMOVAL OF TOOTH R 801.40 - R 593.60 - -

8941 SURGICAL REMOVAL OF IMPACTED TOOTH - FIRST TOOTHR 1 294.40 - R 984.30 - -

8943 SURGICAL REMOVAL OF IMPACTED TOOTH - SECOND TOOTHR 697.40 - R 528.10 - -

8945 SURGICAL REMOVAL OF IMPACTED TOOTH - THIRD AND

SUBSEQUENT TEETH R 395.70 - R 300.00 - -

8953 SURGICAL REMOVAL OF RESIDUAL ROOTS, FIRST TOOTH - PER TOOTHR 801.40 - R 801.30 - -

8957 ALVEOLOTOMY OR ALVEOLECTOMY (INCLUDING EXTRACTIONS)R 1 093.30 - R 728.90 - -

8958 EMERGENCY TRACHEOTOMY * * - - - -

8959 PHARYNGOSTOMY * * - - - -

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8961 TOOTH TRANSPLANTATION R 1 792.40 - - - -

8962 HARVEST ILIAC CREST GRAFT R 541.40 - - - -

8963 HARVEST RIB GRAFT R 758.00 - - - -

8964 HARVEST CRANIUM GRAFT R 593.60 - - - -

8965 PERIPHERAL NEURECTOMY R 1 792.40 - - - -

8966 REPAIR OF ORONASAL FISTULA (LOCAL FLAPS) * * - - - -

8967 SURGICAL REMOVAL OF JAW CYST - INTRA-ORAL APPROACHR 2 490.00 - - - -

8969 SURGICAL REMOVAL OF JAW CYST - EXTRA-ORAL APPROACHR 3 988.80 - - - -

8971 EXCISION OF TUMOUR OF THE SOFT TISSUE R 801.40 - R 801.40 - -

8973 SURGICAL EXCISION OF TUMOURS OF THE JAW R 3 988.80 - - - -

8975 HEMIRESECTION OF JAW EXCLUDING CONDYL * * - - - -

8977 SURGICAL REPAIR OF MAXILLA OR MANDIBLE - MAJOR R 4 186.70 - - - -

8979 HARVESTING OF AUTOGENOUS GRAFTS (INTRA-ORAL) R 345.30 - R 345.30 - -

8981 SURGICAL EXPOSURE OF IMPACTED OR UNERUPTED TEETH TO AID

ERUPTION R 1 494.00 - R 1 494.00 - -

8983 CORTICOTOMY - FIRST TOOTH R 1 190.40 - - - -

8984 CORTICOTOMY - EACH ADDITIONAL TOOTH R 603.70 - - - -

8985 FRENULECTOMY/FRENULOTOMY R 1 093.30 - R 1 093.30 - -

8987 REDUCTION OF MYLOHYOID RIDGES - PER SIDE R 1 792.40 - - - -

8989 REMOVAL TORUS MANDIBULARIS R 1 792.40 - - - -

8991 REMOVAL OF TORUS PALATINUS R 1 792.40 - - - -

8993 SURGICAL REDUCTION OF OSSEOUS TUBEROSITY - PER SIDER 801.40 - - - -

8995 GINGIVECTOMY - PER JAW R 1 594.70 - - - -

8997 SULCOPLASTY / VESTIBULOPLASTY R 4 109.70 - R 4 109.70 - -

9003 REPOSITION MENTAL FORAMEN AND NERVE - PER SIDE R 2 490.00 - - - -

9004 LATERALIZATION OF INFERIOR DENTAL NERVE R 4 012.40 - - - -

9005 ALVEOLAR RIDGE AUGMENTATION - TOTAL (BY BONE GRAFT)R 4 190.10 - R 4 190.10 - -

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9007 ALVEOLAR RIDGE AUGMENTATION - TOTAL (BY ALLOPLASTIC

MATERIAL) R 2 637.40 - - - -

9008 ALVEOLAR RIDGE AUGMENTATION - ONE TO TWO TOOTH SITESR 994.30 - R 994.30 - -

9009 ALVEOLAR RIDGE AUGMENTATION - THREE ACROSS 3 OR MORE

TOOTH SITES R 1 812.40 - R 1 812.40 - -

9010 SINUS LIFT PROCEDURE R 2 723.00 - R 2 723.00 - -

9011 INCISION & DRAINAGE OF ABSCESS - INTRA-ORAL (PYOGENIC)R 509.70 - - - -

9013 INCISION & DRAINAGE OF ABSCESS - EXTRA-ORAL (PYOGENIC) * * - * - -

9015 APICECTOMY/PERIRADICULAR SURGERY - ANTERIORS (INCLUDING

RETROGRADE FILLING) R 898.70 - R 898.70 - R 898.70

9016 APICECTOMY/PERIRADICULAR SURGERY - MOLARS (INCLUDING

RETROGRADE FILLING) R 1 792.40 - R 1 792.40 - R 1 792.40

9017 DECORTICATION, SAUCERISATION AND SEQUESTRECTOMY * * - - - -

9019 SEQUESTRECTOMY - INTRA ORAL PER SEXTANT AND OR RAMUSR 801.40 - - - -

9021 SUTURE - RECONSTRUCTION, MINOR (EXCLUDES CLOSURE OF

SURGICAL INCISIONS) R 898.70 - - - -

9023 SUTURE - RECONSTRUCTION, MAJOR (EXCLUDES CLOSURE OF

SURGICAL INCISIONS) R 1 891.40 - - - -

9024 DENTO-ALVEOLAR FRACTURE - PER SEXTANT R 898.70 - - - -

9025 MANDIBLE FRACTURE - CLOSED REDUCTION * * - - - -

9027 MANDIBLE FRACTURE - COMPOUND, WITH EYELET WIRING * * - - - -

9029 MANDIBLE FRACTURE - SPLINTS * * - - - -

9031 MANDIBLE FRACTURE - OPEN REDUCTION * * - - - -

9032 REDUCTION OF MASSETER MUSCLE AND BONE - EXTRA-ORAL

APPROACH * - - - -

9033 OPEN TREATMENT OF CONDYLAR FRACTURE * - - - -

9035 MAXILLA FRACTURE - LE FORT I OR GUERIN * * - - - -

9036 OPEN TREATMENT OF MAXILLARY FRACTURE - LE FORT I * - - - -

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9037 MAXILLA FRACTURE - LE FORT II OR MIDDLE THIRD FACE * * - - - -

9038 OPEN TREATMENT OF MAXILLARY FRACTURE - LE FORT II MIDDLE

THIRD OF FACE * - - - -

9039 MAXILLA FRACTURE - LE FORT III OR CRANIOFACIAL DISJUNCTION * * - - - -

9041 ZYGOMATIC ARCH FRACTURE - CLOSED REDUCTION * * - - - -

9043 ZYGOMATIC ARCH FRACTURE - OPEN REDUCTION * * - - - -

9045 ZYGOMATIC ARCH FRACTURE - OPEN REDUCTION (REQUIRING

OSTEOSYNTHESIS AND/OR GRAFTING) * * - - - -

9046 PLACEMENT OF ZYGOMATICUS FIXTURE, PER FIXTURE * * - - - -

9047 OSTEOTOMY - OPEN WITH STABILISATION * * * * - *

9048 SURGICAL REMOVAL OF INTERNAL FIXATION DEVICES, PER SITE * * - * - -

9049 OSTEOTOMY - MANDIBLE BODY, ANTERIOR SEGMENTAL * * * * - *

9050 OSTEOTOMY - TOTAL SUBAPICAL * * * * - *

9051 GENIOPLASTY * * * * - *

9052 MIDFACIAL EXPOSURE * * * * - *

9053 CORONOIDECTOMY (INTRA-ORAL APPROACH) * * * * - *

9055 OSTEOTOMY - SEGMENTED, POSTERIOR * * * * - *

9057 OSTEOTOMY - SEGMENTED, ANTERIOR * * * * - *

9059 RECONSTRUCT MAXILLA - LE FORT I OSTEOTOMY, ONE PIECE * * * * - *

9060 RECONSTRUCT MAXILLA - LE FORT I OSTEOTOMY W/ REPOSITIONING

AND GRAFT * * * * - *

9061 PALATAL OSTEOTOMY * * * * - *

9062 RECONSTRUCT MAXILLA - LE FORT I OSTEOTOMY, MULTIPLE

SEGMENTS * * * * - *

9063 RECONSTRUCT MAXILLA - LE FORT 2 OSTEOTOMY (FACIAL AND POST-

TRAUMATIC DEFORMITIES) * * * * - *

9065 RECONSTRUCT MAXILLA - LE FORT 3 OSTEOTOMY (SEVERE

CONGENITAL DEFORMITIES) * * * * - *

9066 SURGICAL EXPANSION - MAXILLIARY OR MANDIBULAR * * * * - *

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9067 DISTRACTION OSTEOGENESIS - ACROSS ONE TO TWO TOOTH SITES - - - - -

9068 DISTRACTION OSTEOGENESIS - ACROSS THREE TO FIVE TOOTH SITES - - - - -

9069 GLOSSECTOMY - PARTIAL * * * * - *

9070 DISTRACTION OSTEOGENESIS - FULL ARCH - - - - -

9071 GENIOHYOIDOTOMY * * * * - *

9072 CLOSE SECONDARY ORO-NASAL FISTULA W/ BONE GRAFTING

(COMPLETE PROCEDURE) * * * * - *

9074 TMJ ARTHROSCOPY DIAGNOSTIC * * - - - -

9075 CONDYLECTOMY, CORONOIDECTOMY OR BOTH * * * * - *

9076 TMJ ARTROCENTESIS * * - - - -

9077 TMJ INTRA-ARTICULAR INJECTION * * - - - -

9079 TRIGGER POINT INJECTION * * - - - -

9081 CONDYLECTOMY (WARD/KOSTECKA) * * * * - *

9083 TMJ SRTHROPLASTY * * - - - -

9085 REDUCTION OF TMJ DISLOC W/O ANAESTHETIC * * - - - -

9087 REDUCTION OF TMJ DISLOC W/ ANAESTHETIC * * - - - -

9089 REDUCTION OF TMJ DISLOC W/ ANAESTHETIC AND

IMMOBOBILISATION * * - - - -

9091 REDUCTION OF TMJ DISLOCATION - OPEN REDUCTION * * - - - -

9092 JOINT RECONSTRUCTION * * - - - -

9093 REMOVAL OF SALIVARY STONE (SIALOLITHOTOMY) R 898.70 - - - -

9095 EXCISION OF SUBLINGLUAL SALIVARY GLAND * * - - - -

9096 EXCISION OF SALIVARY GLAND - EXTRA ORAL APPROACH * * - - - -

9099 UNLISTED DENTAL PROCEDURE OR SERVICE (BY REPORT) * * * * - *

9101 OBTURATOR PROSTHESIS, SURGICAL - MODIFIED DENTURE * - - - - *

9102 OBTURATOR PROSTHESIS, SURGICAL - CONTINUOUS BASE * - - - - *

9103 OBTURATOR PROSTHESIS, SURGICAL - SPLIT BASE * - - - - *

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9104 OBTURATOR PROSTHESIS, INTERIM - ON EXISTING DENTURE * - - - - *

9105 OBTURATOR PROSTHESIS, INTERIM - ON NEW DENTURE * - - - - *

9106 OBTURATOR PROSTHESIS, DEFINITIVE - OPEN/HOLLOW BOX * - - - - *

9107 OBTURATOR PROSTHESIS, DEFINITIVE - SILICONE GLOVE * - - - - *

9108 MANDIBULAR RESECTION PROSTHESIS W/ GUIDE FLANGE * - - - - *

9109 MANDIBULAR RESECTION PROSTHESIS W/O GUIDE FLANGE * - - - - *

9110 MANDIBULAR RESECTION PROSTHESIS, PALATAL AUGMENTATION * - - - - *

9111 GLOSSAL RESECTION PROSTHESIS - SIMPLE * - - - - *

9112 GLOSSAL RESECTION PROSTHESIS - COMPLEX * - - - - *

9113 RADIATION CARRIER - SIMPLE * - - - - *

9114 RADIATION CARRIER - COMPLEX * - - - - *

9115 RADIATION SHIELD - SIMPLE * - - - - *

9116 RADIATION SHIELD - COMPLEX * - - - - *

9117 RADIATION CONE LOCATOR * - - - - *

9118 CHEMOTHERAPEUTIC AGENT CARRIER * - - - - *

9119 FEEDING AID PROSTHESIS, NEONATAL * - * - - *

9120 ORTHOPAEDIC APPLIANCE, ACTIVE PRESURGICAL - MINOR * - * - - *

9121 ORTHOPAEDIC APPLIANCE, ACTIVE PRESURGICAL - MODERATE * - * - - *

9122 ORTHOPAEDIC APPLIANCE, ACTIVE PRESURGICAL - SEVERE * - * - - *

9123 ORTHOPAEDIC APPLIANCE, ACTIVE PRESURGICAL - MODIFICATION * - * - - *

9125 SPEECH AID/OBTURATOR PROSTHESIS - PALATAL ALTERATION * - - - - *

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9126 SPEECH AID/OBTURATOR PROSTHESIS - VELAR ALTERATION * - - - - *

9127 SPEECH AID/OBTURATOR PROSTHESIS - PHARYNGEAL ALTERATION * - - - - *

9128 SPEECH AID/OBTURATOR PROSTHESIS - MODIFICATION * - - - - *

9129 SPEECH AID/OBTURATOR PROSTHESIS - SURGICAL * - - - - *

9130 SPEECH AID APPLIANCE - PALATAL LIFT * - - - - *

9131 SPEECH AID APPLIANCE - PALATAL STIMULATING * - - - - *

9132 SPEECH AID APPLIANCE - BULB * - - - - *

9133 SPEECH AID APPLIANCE - MODIFICATION * - - - - *

9134 UNSPECIFIED SPEECH AID APPLIANCE * - - - - *

9135 AURICULAR PROSTHESIS - SIMPLE * - - - - *

9136 AURICULAR PROSTHESIS - COMPLEX * - - - - *

9137 NASAL PROSTHESIS - SIMPLE * - - - - *

9138 NASAL PROSTHESIS - COMPLEX * - - - - *

9139 OCULAR PROSTHESIS - INTERIM * - - - - *

9140 OCULAR PROSTHESIS - MODIFIED STOCK APPLIANCE * - - - - *

9141 OCULAR PROSTHESIS - CUSTOM APPLIANCE * - - - - *

9142 ORBITAL PROSTHESIS - SIMPLE * - - - - *

9143 ORBITAL PROSTHESIS - COMPLEX * - - - - *

9148 UNSPECIFIED BODY PROSTHESIS - SIMPLE * - - - - *

9149 UNSPECIFIED BODY PROSTHESIS - COMPLEX * - - - - *

9150 FACIAL PROSTHESIS, SURGICAL - SIMPLE * - - - - *

9151 FACIAL PROSTHESIS, SURGICAL - COMPLEX * - - - - *

9155 CRANIAL PROSTHESIS * - - - - *

9156 CRANIAL IMPLANT PROSTHESIS, CUSTOM MADE * - - - - *

9157 FACIAL IMPLANT PROSTHESIS, CUSTOM MADE - SIMPLE * - - - - *

9158 FACIAL IMPLANT PROSTHESIS, CUSTOM MADE - COMPLEX * - - - - *

9159 OCULAR IMPLANT PROSTHESIS, CUSTOM MADE * - - - - *

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Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

9160 BODY IMPLANT PROSTHESIS - CUSTOM MADE * - - - - *

9161 SURGICAL SPLINT - SIMPLE * - - - - *

9162 SURGICAL SPLINT - COMPLEX * - - - - *

9163 SURGICAL TEMPLATE - SIMPLE * - - - - *

9164 SURGICAL TEMPLATE - COMPLEX * - - - - *

9165 SURGICAL CONFORMER - SIMPLE * - - - - *

9166 SURGICAL CONFORMER - COMPLEX * - - - - *

9167 TRISMUS APPLIANCE (SIMPLE) * - - - - *

9168 TRISMUS APPLIANCE (COMPLEX) * - - - - *

9169 ORTHOSES APPLIANCE * - - - - *

9170 FACIAL PALSY APPLIANCE * - - - - *

9171 COMMISSURE SPLINT * - - - - *

9172 ORAL RETRACTOR, DYNAMIC - PER ARM * - - - - *

9174 UNSPECIFIED BURN APPLIANCE - - - - -

9175 THEATRE ATTENDANCE (MAXFAC PROSTHOD) /HOUR - - - - -

9180 SURGICAL PLACEMENT OF SUB-PERIOSTEAL IMPLANT - PREPARATORY

STAGE * R 1 808.50 - - - -

9181 SURGICAL PLACEMENT OF SUB-PERIOSTEAL IMPLANT - PLACEMENT

STAGE * R 1 808.50 - - - -

9182 SURGICAL PLACEMENT OF ENDOSTEAL IMPLANT PLATE * R 1 358.10 - R 1 358.10 - -

9183 SURGICAL PLACEMENT OF ENDOSSEUS IMPLANT - FIRST PER

QUADRANT * R 1 732.00 - R 1 732.00 - R 1 731.80

9184 SURGICAL PLACEMENT OF ENDOSSEUS IMPLANT - SECOND PER

QUADRANT * R 1 299.40 - R 1 299.40 - R 1 298.90

9185 SURGICAL PLACEMENT OF ENDOSSEUS IMPLANT - THIRD AND

SUBSEQUENT PER QUADRANT * R 870.30 - R 870.30 - *

9187 COST OF ENDOSTEAL IMPLANT BODY * * - * * *

9188 COST OF PREFABRICATED ABUTMENT * * - * * *

9189 COST OF OTHER IMPLANT COMPNTS * * - * * *

9190 SURGICAL EXPOSURE OF ENDOSSEUS IMPLANT - FIRST PER

QUADRANT * R 640.40 - R 640.40 - R 640.40

9191 SURGICAL EXPOSURE OF ENDOSSEUS IMPLANT - SECOND PER

QUADRANT * R 481.30 - R 481.30 - R 481.30

Trf


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Maxillo-Facial &

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Orthodontic

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Dental

Technician (93)

Prostondontic

(94)

9192 SURGICAL EXPOSURE OF ENDOSSEUS IMPLANT - THIRD AND

SUBSEQUENT PER QUADRANT * R 323.70 - R 323.70 - R 323.70

9198 SURGICAL REMOVAL OF IMPLANT * R 883.70 - R 883.70 - R 589.20

9201 CONSULTATION - ORAL PATHOLOGIST - - - - -

9203 HOUSE/HOSP/NURSING HOME CONSULTATION - ORAL PATHOLOGIST - - - - -

9205 CONSULTATION - ORAL PATHOLOGIST (SUBSEQUENT) - - - - -

9207 AFTER HOURS VISIT - ORAL PATHOLOGIST - - - - -

9220 REPAIR CLEFT HARD PALATE - UNILATERAL * * - - - -

9222 REPAIR CLEFT HARD PALATE - BILATERAL (ONE PROCEDURE) * * - - - -

9224 REPAIR CLEFT HARD PALATE - BILATERAL (TWO PROCEDURES) * * - - - -

9226 REPAIR CLEFT SOFT PALATE - W/O MUSCLE RECONSTRUCTION * * - - - -

9228 REPAIR CLEFT SOFT PALATE - W/ MUSCLE RECONSTRUCTION * * - - - -

9230 REPAIR SUBMUCOSAL CLEFT AND/OR BIFID UVULA - W/ MUSCLE

RECONSTRUCTION * * - - - -

9232 VELOPHARYNGEAL RECONSTRUCTION - UNCOMPLICATED * * - - - -

9234 VELOPHARYNGEAL RECONSTRUCTION - COMPLICATED * * - - - -

9238 REPAIR ORONASAL FISTULA (ONE PROCEDURE) * * - - - -

9240 REPAIR ORONASAL FISTULA (TWO PROCEDURES) * * - - - -

9246 SECONDARY PERIOSTEAL FLAPS * * - - - -

9248 LIPADHESION * * - - - -

9250 REPAIR CLEFT LIP - UNILATERAL W/O MUSCLE RECONSTRUCTION * * - - - -

9252 REPAIR CLEFT LIP - UNILATERAL W/ MUSCLE RECONSTRUCTION * * - - - -

9254 REPAIR CLEFT LIP - BILATERAL W/O MUSCLE RECONSTRUCTION * * - - - -

9256 REPAIR CLEFT LIP - BILATERAL W/ MUSCLE RECONSTRUCTION * * - - - -

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Orthodontic

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(92)

Dental

Technician (93)

Prostondontic

(94)

9258 REPAIR ANTERIOR NASAL FLOOR * * - - - -

9260 REVISION OF SECONDARY CLEFT LIP DEFORMITY - PARTIAL * * - - - -

9262 REVISION OF SECONDARY CLEFT LIP DEFORMITY - TOTAL W/ MUSCLE

RECONSTRUCTION * * - - - -

9264 ABBE-FLAP - TWO STAGES * * - - - -

9266 RECONSTRUCT COLUMELLA * * - - - -

9268 RECONSTRUCT NOSE DUE TO CLEFT DEFORMITY - PARTIAL * * - - - -

9270 RECONSTRUCT NOSE DUE TO CLEFT DEFORMITY - COMPLETE * * - - - -

9272 PARANASAL AUGMENTATION FOR NASAL BASE DEVIATION * * - - - -

9274 REPAIR ANTERIOR TABLE, FRONTAL SINUS AND/OR SUPRAORBITAL

RIM - - - - -

9276 REPAIR ANTERIOR AND POSTERIOR WALL W/ OBTURATION AND/OR

CRANIALISATION OF FRONTAL SINUS - - - - -

9278 REPAIR MEDIAL CANTHAL LIGAMENT (CANTHOPEXY), PER SIDE - - - - -

9280 OPEN REDUCTION AND FIXATION OF NASAL FRACTURES - - - - -

9282 MANIPULATION AND IMMOBILISATION OF NASAL FRACTURE - - - - -

9284 MUSCULOFASCIAL FLAP - - - - -

9286 MUSCULOCRANIAL FLAP - - - - -

9288 BUCCAL FAT PAD (MAJOR REPAIR) - - - - -

9290 MAXILLECTOMY - ALVEOLUS ONLY, LEVEL I - - - - -

9292 MAXILLECTOMY - ALVEOLUS AND SINUS OR NASAL FLOOR, LEVEL II - - - - -

9294 MAXILLECTOMY - ALVEOLUS, SINUS, NASAL FLOOR AND ZYGOMA

EXCLUDING ORBITAL RIM LEVEL III - - - - -

9296 MAXILLECTOMY - ALVEOLUS, SINUS, NASAL FLOOR AND ZYGOMA

INCLUDING ORBITAL RIM LEVEL IV - - - - -

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(92)

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Technician (93)

Prostondontic

(94)

9298 MAXILLECTOMY - ALVEOLUS, SINUS, NASAL FLOOR, ZYGOMA,

ORBITAL RIM AND PTERYGOID PLATES LEVEL V - - - - -

9300 HEMIRESECTION OF JAW INCLUDING CONDYLE AND CORONOID

PROCESS - - - - -

9301 CASTING AND TRIMMING OF MODEL IN PLASTER (YELLOW/WHITE),

PER MODEL R 39.10 R 39.10 R 39.10 R 39.10 R 39.10

9303 CASTING AND TRIMMING OF MODEL IN SUPER-HARD STONE (DIE-

STONE) PER MODEL R 55.60 R 55.60 R 55.60 R 55.60 R 55.60

9305 CASTING AND TRIMMING OF STUDY MODEL, PER MODELR 103.00 R 103.00 R 103.00 R 103.00 R 103.00

9307 CASTING AND TRIMMING OF GNATHOSTATIC MODEL, PER MODEL.R 133.90 R 133.90 R 133.90 R 133.90 R 133.90

9309 NEW TRIMMED BASE TO SUPPLIED MODEL, PER MODELR 47.40 R 47.40 R 47.40 R 47.40 R 47.40

9311 TRIMMING OF SUPPLIED MODEL, PER MODEL R 28.80 R 28.80 R 28.80 R 28.80 R 28.80

9312 GINGIVAL TISSUE MASK PER IMPLANT R 222.50 R 222.50 R 222.50 R 222.50 R 222.50

9313 DUPLICATING MODEL, PER MODEL R 119.50 R 119.50 R 119.50 R 119.50 R 119.50

9314 REFRACTORY MODEL, PER UNIT R 117.40 R 117.40 R 117.40 R 117.40 R 117.40

9315 MODELS AND DUPLICATE MODELS (VIRGIN MODEL) FOR CROWN AND

BRIDGE, WORK INCLUSIVE OF ONE REMOVABLE DIE - - R 162.70 R 162.70 R 162.70

9317 SECTIONAL MODELS FOR CROWN AND BRIDGE, WORK INCLUSIVE OF

ONE REMOVABLE DIE - - - R 144.20 R 144.20

9319 EACH ADDITIONAL REMOVABLE DIE FOR ITEMS 9315 AND 9317 PER

DIE - - R 37.10 R 37.10 R 37.10

9320 INDEXED OR MODEL TRAY PER DIE (NOT MORE THAN 9319) - - - R 37.10 R 37.10

9321 OCCLUSION BLOCK, PER BLOCK R 142.10 - - R 142.10 R 142.10

9323 OCCLUSION BLOCK ON BASEPLATE, PER BLOCK - - - R 179.20 R 179.20

9327 INFECTION CONTROL PER IMPRESSION, DENTURE (WAX OR ACRYLIC)

OR ANY ITEM IN CONTACT WITH BODY FLUIDSR 26.80 R 26.80 R 26.80 R 26.80 R 26.80

9329 FIT AND SUPPLY OF DISPOSABLE ARTICULATOR - R 70.00 - R 70.00 R 70.00

Trf


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Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

9330 DELIVERY / COLLECTION FEE PER COMPLETED PROCEDURE

(MAXIMUM 4) - - - - -

9331 FULL UPPER AND LOWER DENTURES R 1 911.70 - - R 1 911.70 R 1 911.70

9333 FULL UPPER OR LOWER DENTURE - - - R 1 118.60 R 1 118.60

9335 SET-UP AND WAXING OF FULL UPPER AND LOWER DENTURES - - - R 659.20 R 659.20

9337 SET-UP AND WAXING OF FULL UPPER OR LOWER DENTURE - - - R 440.80 R 440.80

9339 WAXING AND FINISHING OF FULL UPPER AND LOWER DENTURES - - - R 1 172.10 R 1 172.10

9341 WAXING AND FINISHING OF FULL UPPER OR LOWER DENTURE - - - R 655.10 R 655.10

9343 ADDITIONAL FEE FOR DENTURES ON FULLY ADJUSTABLE

ARTICULATOR AT REQUEST OF DENTIST - - - R 1 866.40 R 1 866.40

9345 ADDITIONAL FEE FOR IMMEDIATE DENTURES, OR TOOTH SOCKETED - - - R 26.80 R 26.80

9346 ADDITIONAL FEE FOR IMMEDIATE DENTURES, PER TOOTH NOT

SOCKETED. - - R 14.40 R 14.40 R 14.40

9347 ADDITIONAL FEE FOR EACH RETRY FROM THE THIRD AND UPWARDS

AT AN AGREED QUANTUM OF TIME TO BE CALCULATED AT HOURLY

RATE - - - R 424.40 R 424.40

9351 SET-UP AND FINISH OF ONE-TOOTH DENTURE - - R 512.90 R 512.90 R 512.90

9352 SET-UP AND FINISH OF TWO-TOOTH DENTURE - - R 545.90 R 545.90 R 545.90

9353 SET-UP AND FINISH OF THREE-TOOTH DENTURE - - R 585.00 R 585.00 R 585.00

9354 SET-UP AND FINISH OF FOUR-TOOTH DENTURE - - R 618.00 R 618.00 R 618.00

9355 SET-UP AND FINISH OF FIVE-TOOTH DENTURE - - R 667.40 R 667.40 R 667.40

9356 SET-UP AND FINISH OF SIX-TOOTH DENTURE - - R 797.20 R 797.20 R 797.20

9357 SET-UP AND FINISH OF SEVEN-TOOTH DENTURE - - R 947.60 R 947.60 R 947.60

9358 SET-UP AND FINISH OF EIGHT-TOOTH DENTURE - - R 1 005.30 R 1 005.30 R 1 005.30

9359 SET-UP AND FINISH NINE OR MORE TOOTH DENTURE - - R 1 030.00 R 1 030.00 R 1 030.00

9361 SET-UP AND WAXING OF ONE-TOOTH DENTURE - - R 146.30 R 146.30 R 146.30

9362 SET-UP AND WAXING OF TWO-TOOTH DENTURE - - R 177.20 R 177.20 R 177.20

9363 SET-UP AND WAXING OF THREE-TOOTH DENTURE - - R 201.90 R 201.90 R 201.90

Trf


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Technician (93)

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(94)

9364 SET-UP AND WAXING OF FOUR-TOOTH DENTURE - - R 234.80 R 234.80 R 234.80

9365 SET-UP AND WAXING OF FIVE-TOOTH DENTURE - - R 259.60 R 259.60 R 259.60

9366 SET-UP AND WAXING OF SIX-TOOTH DENTURE - - R 306.90 R 306.90 R 306.90

9367 SET-UP AND WAXING OF SEVEN-TOOTH DENTURE - - R 337.80 R 337.80 R 337.80

9368 SET-UP AND WAXING OF EIGHT-TOOTH DENTURE - - R 362.60 R 362.60 R 362.60

9369 SET-UP AND WAXING OF NINE OR MORE TOOTH DENTURE - - R 387.30 R 387.30 R 387.30

9371 WAXING AND FINISHING OF ONE-TOOTH DENTURE - - R 401.70 R 401.70 R 401.70

9372 WAXING AND FINISHING OF TWO-TOOTH DENTURE - - R 409.90 R 409.90 R 409.90

9373 WAXING AND FINISHING OF THREE-TOOTH DENTURE - - R 416.10 R 416.10 R 416.10

9374 WAXING AND FINISHING OF FOUR-TOOTH DENTURE - - R 424.40 R 424.40 R 424.40

9375 WAXING AND FINISHING OF FIVE-TOOTH DENTURE - - R 440.80 R 440.80 R 440.80

9376 WAXING AND FINISHING OF SIX-TOOTH DENTURE - - R 457.30 R 457.30 R 457.30

9377 WAXING AND FINISHING OF SEVEN-TOOTH DENTURE - - R 570.60 R 570.60 R 570.60

9378 WAXING AND FINISHING OF EIGHTH-TOOTH DENTURE - - R 593.30 R 593.30 R 593.30

9379 WAXING AND FINISHING OF NINE OR MORE TOOTH DENTURE - - R 626.20 R 626.20 R 626.20

9383 ADDITIONAL FEE FOR FINISHING DENTURE IN TOOTH COLOUR

MATERIAL, PER TOOTH - - R 98.90 R 98.90 R 98.90

9385 ADDITIONAL FEE FOR SUPPLYING FINISHED DENTURE ON DUPLICATE

MODEL - - R 187.50 R 187.50 R 187.50

9391 BASIC CHARGE WHICH INCLUDES REPAIR OF ONE FRACTURE, OR

ADDITION OF ONE TOOTH, OR ADDITION OF ONE CLASP - R 325.50 R 325.50 R 325.50 R 325.50

9393 ADDITIONAL CHARGE FOR EACH ADDITIONAL FRACTURE, OR TOOTH,

OR CLASP - R 100.90 R 100.90 R 100.90 R 100.90

9395 ADDITIONAL FEE FOR USING WIRE STRENGTHENER - R 115.40 R 115.40 R 115.40 R 115.40

9397 ADDITIONAL FEE FOR USING PRE-FORMED STRENGTHENER - R 123.60 R 123.60 R 123.60 R 123.60

9398 ADDITIONAL FEE FOR USING MESH STRENGTHENER IN REPAIR

PROCEDURE - - R 195.70 R 195.70 R 195.70

9401 CLEAR BASE - - - - -

9403 DOX GRINDING OF UPPER AND LOWER DENTURES - - R 183.30 R 183.30 R 183.30

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Maxillo-Facial &

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(92)

Dental

Technician (93)

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(94)

9405 INLAY TO ARTIFICIAL TOOTH, ONE SURFACE ONLY, PER INLAY - - - - -

9406 INLAY TO ARTIFICIAL TOOTH, MULTI-SURFACES E.G. HORSESHOE OR L-

TYPE INLAY, PER INLAY - - - - -

9407 HEKA BASE TECHNIQUE PER UPPER OR LOWER DENTURE - - R 432.60 R 432.60 R 432.60

9409 FREGO FRAME - - R 187.50 R 187.50 R 187.50

9410 BLEACHING TRAY - - - - -

9411 TEMPLATE PER UPPER OR LOWER DENTURE - - R 517.10 R 517.10 R 517.10

9413 RELINE/REBASE OF SINGLE DENTURE - - R 651.00 R 651.00 R 651.00

9415 REMODEL OF SINGLE DENTURE - - R 1 001.20 R 1 001.20 R 1 001.20

9417 SOFT BASE RELINE PER DENTURE - - R 1 643.90 R 1 643.90 R 1 643.90

9419 SOFT BASE TO NEW DENTURE, PER DENTURE - - R 1 643.90 R 1 643.90 R 1 643.90

9421 GUM TINTING PER DENTURE - - - - -

9423 LINGUAL OR PALATAL BAR - R 245.10 R 245.10 R 245.10 R 245.10

9425 CLEANING AND POLISHING OF EXISTING DENTURE, PER DENTURE - - R 199.80 R 199.80 R 199.80

9427 MESH STRENGTHENER - - R 171.00 R 171.00 R 171.00

9429 THEATRE/ CONSULTATION OUT OF LABORATORY PER HOUR OR PART

THEREOF R 424.40 - R 424.40 R 424.40 R 424.40

9431 SPECIAL TRAY, ACRYLIC, EACH - - R 160.70 R 160.70 R 160.70

9432 SPECIAL TRAY LIGHT CURE, EACH - - R 175.10 R 175.10 R 175.10

9433 SPECIAL TRAY IN BASE PLATE MATERIAL, EACH - - R 164.80 R 164.80 R 164.80

9435 PROVISION OF SINGLE ARM CLASP, TO PARTIAL DENTURE - - R 84.50 R 84.50 R 84.50

9437 PROVISION OF DOUBLE ARM CLASP, TO PARTIAL DENTURE - - R 146.30 R 146.30 R 146.30

9439 PROVISION OF SINGLE ARM CLASP WITH REST, TO PARTIAL DENTURE - - R 189.50 R 189.50 R 189.50

9441 PROVISION OF DOUBLE ARM CLASP WITH REST, TO PARTIAL DENTURE - - R 255.40 R 255.40 R 255.40

9443 PROVISION OF PREFORMED ROACH CLASP, TO PARTIAL DENTURE - - R 109.20 R 109.20 R 109.20

9445 PROVISION OF REST ONLY TO PARTIAL DENTURE - - R 109.20 R 109.20 R 109.20

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Maxillo-Facial &

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(92)

Dental

Technician (93)

Prostondontic

(94)

9447 CAST CLASP - - R 383.20 R 383.20 R 383.20

9448 CASTING AND TRIMMING OF MODEL FROM IMPRESSION INSIDE

OCCLUSION BLOCK OR WAX TRY IN - - R 70.00 R 70.00 R 70.00

9450 FINISHING OF ACRYLIC WORK ON ANY CHROME COBALT OR GOLD

PROSTHESIS R 146.30 R 146.30 R 146.30 R 146.30 R 146.30

9451 METAL BASE FOR FULL UPPER OR FULL LOWER DENTURE EACH - - - - -

9453 BASIC CHARGE - WHICH EXCLUDES MODELS AND ANY SPECIAL TRAYS

WHICH MAY BE REQUIRED BY THE DENTIST, BUT INCLUDES

REFRACTORY MODEL - - - R 1 147.40 R 1 147.40

9455 ADDITIONAL CHARGE FOR EACH ONE ARM CLASP - - - R 47.40 R 47.40

9457 ADDITIONAL CHARGE FOR EACH ROACH CLASP - - - R 80.30 R 80.30

9459 ADDITIONAL CHARGE FOR EACH REST - - - R 43.30 R 43.30

9461 ADDITIONAL CHARGE FOR CONTINUOUS CLASP, PER TOOTH - - - R 47.40 R 47.40

9463 ADDITIONAL CHARGE FOR LINGUAL BAR, PER TOOTH PASSED - - - R 111.20 R 111.20

9465 ADDITIONAL CHARGE FOR PALATAL BAR - - - R 177.20 R 177.20

9467 ADDITIONAL CHARGE FOR ONLAY - - - - -

9469 ADDITIONAL CHARGE FOR SADDLE WITH FINISHING LINE, PER TOOTH - - - R 78.30 R 78.30

9471 ADDITIONAL CHARGE FOR SADDLE WITHOUT FINISHING LINE, PER

TOOTH - - - R 45.30 R 45.30

9473 ADDITIONAL CHARGE FOR HORSESHOE SADDLE, PER TOOTH - - - R 78.30 R 78.30

9475 ADDITIONAL CHARGE FOR FITTING OF TOOTH TO METAL BACKING,

PER TOOTH - - - R 53.60 R 53.60

9479 ADDITIONAL CHARGE FOR FITTING ONE DISTAL-EXTENSION HINGE - - - R 158.60 R 158.60

9480 ADDITIONAL CHARGE PER MILLED EDGE PER TOOTH - - - R 138.00 R 138.00

9481 ADDITIONAL CHARGE FOR EACH SOLDERING JOINT - - - R 193.60 R 193.60

9483 ADDITIONAL CHARGE FOR SOLDERING RETENTION - - - R 234.80 R 234.80

Trf


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Maxillo-Facial &

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(92)

Dental

Technician (93)

Prostondontic

(94)

9485 ADDITIONAL CHARGE FOR EACH ADDITIONAL RETENTION SOLDERING

JOINT - - - R 72.10 R 72.10

9487 ADDITIONAL CHARGE FOR EACH WELDING JOINT - - - R 236.90 R 236.90

9489 ADDITIONAL CHARGE FOR FITTING SWING LOCK - - - R 193.60 R 193.60

9491 ADDITIONAL CHARGE FOR EACH BACKING CAST - - - R 189.50 R 189.50

9493 ADDITIONAL CHARGE FOR EACH STEELS BACKING OR PONTIC CAST

(PLASTIC WORK TO BE CHARGED IN ADDITION) - - - R 206.00 R 206.00

9495 BASIC FEE FOR THE REPAIRING OF OR ADDITION TO ANY APPLIANCE

NECESSITATING THE CASTING OF A MODEL (9301) - - - R 298.70 R 298.70

9497 BASIC FEE IF A NEW SECTION IS TO BE FABRICATED AND WHERE ITEM

9495 DOES NOT APPLY (9301) - - - R 339.90 R 339.90

9501 CERAMIC JACKET CROWN/CEROMER CROWN OR PONTIC* - - - R 1 304.00 R 1 304.00

9502 CERAMIC METAL SUBSTITUTE COPING * - - - R 1 052.70 R 1 052.70

9505 CERAMIC BONDED CROWN OR PONTIC * - - R 1 624.80 R 1 722.20 R 1 722.20

9507 POST-SOLDER INVESTED JOINT, PER JOINT - - - R 352.30 R 352.30

9511 INLAY IN PORCELAIN VENEER CROWN - - - - -

9512 CERAMIC, INLAY/ONLAY, BRIDGE RETAINER * - - - * *

9513 CERAMIC POST * - - - * *

9515 PORCELAIN SHOULDER PER UNIT (NOT APPLICABLE TO PONTICS) - - R 115.40 R 115.40 R 115.40

9520 ADDITIONAL FEE FOR CROWN- & BRIDGE WORK PERFORMED ON A

MOVABLE CONDYLE ARTICULATOR PER UNIT - - - R 55.60 R 55.60

9521 FULL METAL CROWN, MOD, THREE-QUARTER CROWN * - - - R 1 065.00 R 1 065.00

9524 INDIRECT COMPOSITE RESIN INLAY - - - - -

9525 CLASS IV, MO, DO, CERVICAL/OCCLUSAL INLAY * - - - R 877.60 R 877.60

9526 ADDITIONAL FEE FOR ONE PIECE CASTING OF CROWN OR INLAY ON

POST - - - R 267.80 R 267.80

9531 PIN-LEDGE INLAY - - - - -

9533 FULL METAL PONTIC * - - - R 786.90 R 786.90

Trf


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(94)

9535 ABUTMENT THIMBLE CAST - - - R 737.50 R 737.50

9537 PRECISION LOCK AND REST CAST - - - - -

9538 LOCK AND REST CAST - - - - -

9539 CASTING OF REST ONLY - - - R 298.70 R 298.70

9541 METAL INLAY OR POST, CAST DIRECT - - - - -

9543 GOLD/PRE-SOLDER INVESTED JOINT - - - - -

9545 CAST POST WITH THIMBLE, INDIRECT * - - - R 525.30 R 525.30

9546 MULTIPLE POST * - - - R 869.30 R 869.30

9547 MANUFACTURE CAST POST AND CORE TO EXISTING CROWN* - - - R 686.00 R 686.00

9549 C.S.P. ATTACHMENT (STEIGER) - - - - -

9550 MILLING MILLED EDGE PER UNIT - - - R 737.50 R 737.50

9551 TELESCOPE CROWN - - - - -

9553 COMPOSITE/ACRYLIC VENEER CROWN/PONTIC, INDIRECT* - - - R 1 452.30 R 1 452.30

9557 COMPOSITE/ACRYLIC JACKET CROWN, INDIRECT * - - - R 1 025.90 R 1 025.90

9559 COMPOSITE/ACRYLIC VENEER POST CROWN * - - - R 1 435.80 R 1 435.80

9560 INDIRECT COMPOSITE RESIN VENEER - - - - -

9561 COMPOSITE/ACRYLIC JACKET CROWN, DIRECT * - - - R 700.40 R 700.40

9563 TEMPORARY ACRYLIC/COMPOSITE CROWN PER UNIT - - - - -

9564 HEAT FORMED TEMPLATE SUPPLIED TO DENTIST FOR THE

MANUFACTURE OF TEMPORARY RESTORATIONS - - - - -

9565 COMPOSITE/ACRYLIC-FACING REPLACED - - - R 583.00 R 583.00

9566 PORCELAIN/ CEROMER FACING REPLACED - - - R 1 056.80 R 1 056.80

9569 WAXING OF CROWN TO EXISTING DENTURE - - - R 412.00 R 412.00

9570 ADDITIONAL FEE FOR EACH REMAKE AT AN AGREED QUANTUM OF

TIME TO BE CALCULATED AT AN HOURLY RATE - - - - -

9571 BASIC CHARGE WHICH INCLUDES ACRYLIC BASE R 521.20 R 521.20 R 521.20 R 521.20 R 521.20

9572 BASIC CHARGE NON ACRYLIC BASE - R 251.30 - R 251.30 -

9573 ADDITIONAL CHARGE FOR FITTING FIRST EXPANSION SCREW - R 98.90 - R 98.90 -

Trf


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Maxillo-Facial &

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Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

9575 ADDITIONAL FEE FOR FITTING SUBSEQUENT EXPANSION SCREWS - R 84.50 - R 84.50 -

9576 ADDITIONAL FEE FOR FULL ACLUSAL BITE PLATE R 292.50 R 292.50 R 292.50 R 292.50 R 292.50

9577 ADDITIONAL FEE FOR BITE PLATE ANTERIOR R 98.90 R 98.90 - R 98.90 R 98.90

9578 ADDITIONAL FEE FOR BITE PLATE POSTERIOR R 98.90 R 98.90 - R 98.90 R 98.90

9579 ADDITIONAL FEE FOR FITTING TONGUE GUARD - R 123.60 - R 123.60 -

9581 ADDITIONAL FEE FOR FLAT OR INCLINED PLANE - R 76.20 - R 76.20 -

9583 ADDITIONAL FEE FOR ADAMS CRIB - R 90.60 - R 90.60 -

9585 ADDITIONAL FEE FOR JACKSON CRIB - R 94.80 - R 94.80 -

9587 ADDITIONAL FEE FOR BALL CLASP R 107.10 R 107.10 R 107.10 R 107.10 -

9589 ADDITIONAL FEE FOR SINGLE ARM CLASP - R 82.40 - R 82.40 -

9591 ADDITIONAL FEE FOR DOUBLE ARM CLASP - R 144.20 - R 144.20 -

9593 ADDITIONAL FEE FOR FITTING SINGLE LOOP FINGER SPRING - R 68.00 - R 68.00 -

9595 ADDITIONAL FEE FOR FITTING DOUBLE LOOP FINGER SPRING - R 80.30 - R 80.30 -

9597 ADDITIONAL FEE FOR FITTING BUCCAL RETRACTION SPRING - R 59.70 - R 59.70 -

9599 ADDITIONAL FEE FOR FITTING APRON SPRING - R 154.50 - R 154.50 -

9603 ADDITIONAL FEE FOR FITTING COFFIN SPRING - R 148.30 - R 148.30 -

9605 ADDITIONAL FEE FOR FITTING QUAD HELIX - R 164.80 - R 164.80 -

9607 ADDITIONAL FEE FOR FITTING FLAPPER OR “T”-SPRING - R 123.60 - R 123.60 -

9609 ADDITIONAL FEE FOR FITTING ALL SPRINGS WITH TUBING, EACH - R 138.00 - R 138.00 -

9611 ADDITIONAL FEE FOR FITTING LABIAL ARCH - R 78.30 - R 78.30 -

9613 ADDITIONAL FEE FOR FITTING BUCCAL ARCH - R 92.70 - R 92.70 -

9615 ADDITIONAL FEE FOR FITTING ROBERTS RETRACTOR - R 173.00 - R 173.00 -

9617 INVISIBLE RETAINER - - - - -

9619 ADDITIONAL FEE FOR FITTING TWIN WIRE ARCH EXTRA-ORAL ARCH - R 216.30 - R 216.30 -

9620 ADDITIONAL FEE LIP BUMPER - R 90.60 - R 90.60 -

9621 ADDITIONAL FEE FOR FITTING EXTRA-ORAL ARCH - R 206.00 - R 206.00 -

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

9622 ADDITIONAL FEE FOR FITTING SPACE MAINTAINER ARCH - R 90.60 - R 90.60 -

9623 ADDITIONAL FEE FOR EACH SPOT-WELDING JOINT - R 41.20 - R 41.20 -

9625 ADDITIONAL FEE FOR EACH SOLDERING JOINT - R 65.90 - R 65.90 -

9627 ADDITIONAL FEE FOR EACH INVESTED SOLDERING JOINT - R 183.30 - R 183.30 -

9629 ADDITIONAL FEE FOR EACH HOOK FOR ELASTIC TRACTION - R 59.70 - R 59.70 -

9631 MOUTH PROTECTOR (GUM GUARD) - - - - -

9633 ORAL SCREEN R 475.90 R 475.90 R 475.90 R 475.90 R 475.90

9635 ANDRESEN OR NORWEGIAN APPLIANCE R 850.80 R 850.80 R 850.80 R 850.80 R 850.80

9637 TOOTH POSITIONER - R 980.60 R 980.60 R 980.60 R 980.60

9639 GUNNING SPLINT R 1 306.00 R 1 306.00 R 1 306.00 R 1 306.00 R 1 306.00

9641 FRANKEL APPLIANCE - R 1 260.70 - R 1 260.70 -

9643 CHIN CAP - R 418.20 - R 418.20 -

9645 BIONATOR - R 852.80 - R 852.80 -

9646 DIAGNOSTIC SET-UP - - - - -

9647 SNORING APPLIANCE - - - - -

9651 PINCHED OR SWAGED BAND WITH WELDED ATTACHMENT

(EXCLUDING COST OF ATTACHMENT) - R 251.30 - R 251.30 -

9653 PINCHED OR SWAGED BAND WITH SOLDERED ATTACHMENT - R 329.60 - R 329.60 -

9662 ADDITIONAL FEE FOR EACH REMAKE AT AN AGREED QUANTUM OF

TIME TO BE CALCULATED AT AN HOURLY RATE - - - - -

9700 DIATORICS 1 X 6/8 R 206.20 - R 206.20 R 206.20 R 206.20

9702 DIATORICS, ODDS, ANTERIOR - - R 70.10 R 70.10 R 70.10

9704 DIATORICS, ODDS, POSTERIOR - - R 70.10 R 70.10 R 70.10

9706 COST OF BLEACHING TRAY MATERIAL - - - - -

9720 SOFT BASE MATERIAL PER DENTURE - - R 745.70 R 745.70 R 745.70

9722 ACRYLIC PER DENTURE R 84.40 R 84.40 R 84.40 R 84.40 R 84.40

9724 COST OF PRECISION ATTACHMENT, PER ATTACHMENT - - - - -

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

9726 PREFORMED BALL OR ROACH CLASP R 14.50 R 14.50 R 14.50 R 14.50 R 14.50

9728 COST OF LINGUAL / PALATAL BAR - - - R 168.80 R 168.80

9729 COST OF MESH STRENGTHENER - - - R 88.60 R 88.60

9730 COST OF PRE-FABRICATED BURN-OUT COMPONENT, PER

COMPONENT - - - R 87.70 R 87.70

9732 COST OF OTHER ATTACHMENT COMPONENTS E.G. NYLON CAPS,

SLEEVES ETC - - - - -

9734 COST OF DOLDER BAR AND CLIPS, PER GRAM OR PER CLIP - - - - -

9736 COST OF IMPLANT COMPONENTS * * - * - *

9738 COST OF PREFORMED STRENGTHENER - - - R 88.60 R 88.60

9739 ADDITIONAL CHARGE GOLD PLATING - - - - -

9740 COST OF GOLD WIRE, PER GRAM - - - - -

9741 COST OF COBALT CHROME CASTING ALLOY - - - R 140.00 R 140.00

9742 COST OF SPECIALISED COBALT CHROME CASTING METAL E G

VITALLIUM, TITANIUM - - - - -

9744 COST OF PRECIOUS CASTING ALLOY - - - - -

9746 COST OF SEMI-PRECIOUS CASTING ALLOY - - - - -

9748 COST OF NON-PRECIOUS CASTING ALLOY * - - * * *

9752 COST OF PLATINUM FOIL - - - - -

9754 COST OF GOLD SOLDER, PER GRAM - - - - -

9755 ETCHING FOR BONDING (METAL OR CERAMIC) - - - - -

9756 COST OF SILVER SOLDER, PER GRAM - - - R 51.70 R 51.70

9757 CEROMER MATERIAL - PER UNIT - - - R 1 052.60 R 1 052.70

9758 FIBER RE-ENFORCED MATERIAL PER UNIT - R 346.80 R 346.80 R 346.80 R 346.80

9759 FIBRE POST * - - - * *

9760 COMPOSITE RESTORATION MATERIAL - - - - -

9761 CERAMIC MATERIAL - - - - -

9762 COST OF ANTERIOR ORTHODONTIC ATTACHMENT, PER ATTACHMENT - R 30.70 - R 30.70 -

9763 ORTHODONTIC MATERIAL R 30.70 R 30.70 - R 30.70 -

Trf


*Pre-

authorisation

required

Maxillo-Facial &

Oral Surgery (62)

Orthodontic

(64)

Periodontic

(92)

Dental

Technician (93)

Prostondontic

(94)

9764 COST OF POSTERIOR ORTHODONTIC ATTACHMENT, PER

ATTACHMENT - R 30.70 - R 30.70 -

9765 PREFORMED COMPONENTS - R 16.50 - R 16.50 R 16.50

9766 COST OF EXPANSION SCREW, PER SCREW - R 35.00 - R 35.00 -

9767 SOLDERING MATERIAL - R 8.20 - R 8.20 R 8.20

9768 COST OF BUCCAL TUBE/TRANSFER TUBE, PER TUBE - - - - -

9770 COST OF J-HOOK, PER HOOK - R 32.90 - R 32.90 -

9772 COST OF LINGUAL BUTTONS, PER BUTTON - R 32.90 - R 32.90 R 32.90

9774 COST OF INVISIBLE RETAINER MATERIAL - - - - -

9775 R/A CASE - - - - -

9776 COST OF MOUTH PROTECTOR MATERIAL - - - - -

9778 COST OF ARCH WIRE - R 8.20 - R 8.20 -

9779 DUAL LAMINATE MATERIAL - - - - -

9780 POSITIONING AND FINISHING OF COMPLETE (MALE AND FEMALE)

PREFABRICATED BURN-OUT ATTACHMENT - - - - -

9782 POSITIONING AND SOLDERING OF COMPLETE (MALE AND FEMALE)

PRECISION ATTACHMENT - - - - -

9783 IMPLANT STENT PER UNIT - - - - -

9784 ALIGNMENT OF DOLDER BAR AND CLIPS - - - - -

9786 TRIMMING, WAXING AND FINISHING OF IMPLANT ABUTMENT -

CROWN AND BRIDGE WORK ONLY, PER ABUTMENT - - R 294.60 R 294.60 R 294.60

9787 WAXING, MILLING AND FINISHING OF A CUSTOM ABUTMENT - - - R 574.70 R 574.70

9788 IMPLANT SUPERSTRUCTURE (EDENTULOUS CASES) INCLUDING

PLACING OF PREFORMED PARTS, PER SECTION CAST - - - - -

9789 FINISHING OF PROSTHESIS ON IMPLANT STRUCTURE PER ARCH - - - R 1 147.40 R 1 147.40

medshield 2019 dental tariffs - specialists ......trf code tariffdescription *pre-authorisation...

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