Tooth extractions and insurance
How plans usually pay simple and surgical extractions, why the records decide which one is paid, and what to check before quoting.
Delta Dental lists extractions as basic procedures, often paid at 80%. The National Association of Dental Plans lists oral surgery under major services, so a surgical extraction can land in a different group with a lower percentage.
Simple or surgical
The claim is paid on what the records show. If the notes and X-rays don't support a surgical extraction, insurers may pay it as a simple one (downcoding). Bill what was actually done and keep the notes that show it.
Things to check
- Replacement later. If the tooth will be replaced with an implant or bridge, the plan's missing tooth clause may matter in the future: record the extraction date.
- Wisdom teeth. Some impacted wisdom teeth are billed to medical insurance rather than dental, depending on the plans. Check both if the patient has both.
- A waiting period on basic or major work for a new plan.
This is how plans usually work, not how every plan works. The patient's own plan documents and the insurer decide what's paid.
Codes you'll see
CDT is a registered trademark of the American Dental Association. Tabruns is not affiliated with or endorsed by the ADA. The descriptions here are our own plain-English summaries, not the ADA's official wording; use your current CDT manual or practice software for the official code set.
Terms on this page
Sources
Read November 11, 2026. Where a source describes one insurer's plans, we say so.
Get the patient's share in dollars, from the benefits page
Knowing how plans pay for extractions is half the job. Tabruns reads the coverage, deductible, yearly maximum, waiting periods and frequency limits from the insurer's portal and works out what the patient owes. Patient details stay on the office computer.
Not ready? Try the free patient portion calculator.