NJ PIP Fee Schedule Exhibit 2: Dental Fees
Exhibit 2 prices dental treatment after an automobile accident. Its 323 rows are CDT codes rather than CPT, and each carries a North and a South New Jersey amount. Dental is the one exhibit whose source file prints no copyright notice, although the rule itself makes CDT the American Dental Association's property.
Exhibit 2 in full, all 323 rows
How to read this table
- Code
- A CDT code, the American Dental Association's coding system, not CPT. 11:3-29.2 fixes the edition as CDT 2011-2012.
- North, South
- The fee, chosen by the region where the treatment was given (11:3-29.3(a), which names Exhibit 2 explicitly).
- n/a
- Printed by the State in the cell, not an omission and not a blank. Two codes carry it, both explained below.
D0: diagnostic
28 rows| CDT | North | South |
|---|---|---|
| D0120 | $59.00 | $52.00 |
| D0140 | $91.00 | $80.00 |
| D0150 | $104.00 | $92.00 |
| D0160 | $190.00 | $168.00 |
| D0170 | $85.00 | $75.00 |
| D0180 | $113.00 | $100.00 |
| D0210 | $153.00 | $135.00 |
| D0220 | $34.00 | $30.00 |
| D0230 | $28.00 | $25.00 |
| D0240 | $51.00 | $45.00 |
| D0250 | $80.00 | $71.00 |
| D0260 | $68.00 | $60.00 |
| D0270 | $34.00 | $30.00 |
| D0272 | $53.00 | $47.00 |
| D0273 | $67.00 | $59.00 |
| D0274 | $78.00 | $69.00 |
| D0277 | $119.00 | $105.00 |
| D0290 | $164.00 | $145.00 |
| D0320 | $714.00 | $632.00 |
| D0321 | $248.00 | $219.00 |
| D0330 | $130.00 | $115.00 |
| D0340 | $147.00 | $130.00 |
| D0350 | $88.00 | $78.00 |
| D0360 | $691.00 | $611.00 |
| D0362 | $448.00 | $397.00 |
| D0363 | $482.00 | $427.00 |
| D0460 | $67.00 | $59.00 |
| D0470 | $135.00 | $119.00 |
D1: preventive
9 rows| CDT | North | South |
|---|---|---|
| D1110 | $108.00 | $95.00 |
| D1120 | $79.00 | $70.00 |
| D1351 | $65.00 | $57.00 |
| D1510 | $374.00 | $330.00 |
| D1515 | $509.00 | $451.00 |
| D1520 | $457.00 | $405.00 |
| D1525 | $578.00 | $512.00 |
| D1550 | $101.00 | $89.00 |
| D1555 | $93.00 | $82.00 |
D2: restorative
75 rows| CDT | North | South |
|---|---|---|
| D2140 | $169.00 | $149.00 |
| D2150 | $213.00 | $188.00 |
| D2160 | $256.00 | $226.00 |
| D2161 | $305.00 | $269.00 |
| D2330 | $190.00 | $168.00 |
| D2331 | $238.00 | $210.00 |
| D2332 | $298.00 | $263.00 |
| D2335 | $374.00 | $330.00 |
| D2390 | $549.00 | $486.00 |
| D2391 | $209.00 | $185.00 |
| D2392 | $276.00 | $244.00 |
| D2393 | $338.00 | $299.00 |
| D2394 | $408.00 | $361.00 |
| D2410 | $772.00 | $683.00 |
| D2420 | $860.00 | $761.00 |
| D2430 | $938.00 | $830.00 |
| D2510 | $1,019.00 | $901.00 |
| D2520 | $1,073.00 | $949.00 |
| D2530 | $1,135.00 | $1,005.00 |
| D2542 | $1,183.00 | $1,047.00 |
| D2543 | $1,200.00 | $1,062.00 |
| D2544 | $1,224.00 | $1,083.00 |
| D2610 | $1,070.00 | $946.00 |
| D2620 | $1,142.00 | $1,011.00 |
| D2630 | $1,189.00 | $1,052.00 |
| D2642 | $1,193.00 | $1,056.00 |
| D2643 | $1,245.00 | $1,102.00 |
| D2644 | $1,302.00 | $1,152.00 |
| D2650 | $1,041.00 | $921.00 |
| D2651 | $1,070.00 | $946.00 |
| D2652 | $1,108.00 | $980.00 |
| D2662 | $1,121.00 | $991.00 |
| D2663 | $1,168.00 | $1,034.00 |
| D2664 | $1,223.00 | $1,082.00 |
| D2710 | $1,123.00 | $993.00 |
| D2712 | $1,197.00 | $1,059.00 |
| D2720 | $1,245.00 | $1,102.00 |
| D2721 | $1,189.00 | $1,052.00 |
| D2722 | $1,201.00 | $1,063.00 |
| D2740 | $1,358.00 | $1,202.00 |
| D2750 | $1,302.00 | $1,152.00 |
| D2751 | $1,245.00 | $1,102.00 |
| D2752 | $1,247.00 | $1,104.00 |
| D2780 | $1,250.00 | $1,106.00 |
| D2781 | $1,215.00 | $1,075.00 |
| D2782 | $1,202.00 | $1,064.00 |
| D2783 | $1,297.00 | $1,148.00 |
| D2790 | $1,305.00 | $1,155.00 |
| D2791 | $1,189.00 | $1,052.00 |
| D2792 | $1,238.00 | $1,096.00 |
| D2794 | $1,280.00 | $1,133.00 |
| D2799 | $526.00 | $466.00 |
| D2910 | $130.00 | $115.00 |
| D2915 | $135.00 | $119.00 |
| D2920 | $130.00 | $115.00 |
| D2930 | $321.00 | $284.00 |
| D2931 | $386.00 | $342.00 |
| D2932 | $417.00 | $369.00 |
| D2933 | $440.00 | $390.00 |
| D2934 | $432.00 | $383.00 |
| D2940 | $146.00 | $129.00 |
| D2950 | $323.00 | $285.00 |
| D2951 | $89.00 | $79.00 |
| D2952 | $504.00 | $446.00 |
| D2953 | $374.00 | $330.00 |
| D2954 | $396.00 | $351.00 |
| D2955 | $350.00 | $309.00 |
| D2957 | $243.00 | $215.00 |
| D2960 | $797.00 | $705.00 |
| D2961 | $1,160.00 | $1,027.00 |
| D2962 | $1,360.00 | $1,203.00 |
| D2970 | $453.00 | $401.00 |
| D2971 | $246.00 | $217.00 |
| D2975 | $717.00 | $634.00 |
| D2980 | $351.00 | $310.00 |
D3: endodontics
3 rows| CDT | North | South |
|---|---|---|
| D3310 | $865.00 | $765.00 |
| D3320 | $996.00 | $881.00 |
| D3330 | $1,198.00 | $1,060.00 |
D4: periodontics
9 rows| CDT | North | South |
|---|---|---|
| D4210 | $764.00 | $676.00 |
| D4249 | $912.00 | $807.00 |
| D4260 | $1,272.00 | $1,126.00 |
| D4261 | $1,075.00 | $951.00 |
| D4263 | $851.00 | $753.00 |
| D4341 | $300.00 | $265.00 |
| D4355 | $217.00 | $192.00 |
| D4381 | $180.00 | $159.00 |
| D4910 | $166.00 | $147.00 |
D5: removable prosthodontics
45 rows| CDT | North | South |
|---|---|---|
| D5110 | $2,038.00 | $1,803.00 |
| D5120 | $2,042.00 | $1,807.00 |
| D5130 | $2,207.00 | $1,953.00 |
| D5140 | $2,207.00 | $1,953.00 |
| D5211 | $1,613.00 | $1,427.00 |
| D5212 | $1,613.00 | $1,427.00 |
| D5213 | $2,126.00 | $1,881.00 |
| D5214 | $2,126.00 | $1,881.00 |
| D5510 | $252.00 | $223.00 |
| D5520 | $223.00 | $197.00 |
| D5610 | $242.00 | $214.00 |
| D5620 | $345.00 | $305.00 |
| D5630 | $316.00 | $279.00 |
| D5640 | $218.00 | $193.00 |
| D5650 | $267.00 | $236.00 |
| D5660 | $323.00 | $285.00 |
| D5670 | $890.00 | $787.00 |
| D5671 | $901.00 | $797.00 |
| D5710 | $692.00 | $612.00 |
| D5711 | $686.00 | $607.00 |
| D5720 | $668.00 | $591.00 |
| D5721 | $668.00 | $591.00 |
| D5730 | $441.00 | $391.00 |
| D5731 | $440.00 | $390.00 |
| D5740 | $432.00 | $383.00 |
| D5741 | $440.00 | $390.00 |
| D5750 | $565.00 | $500.00 |
| D5751 | $566.00 | $501.00 |
| D5760 | $560.00 | $496.00 |
| D5761 | $560.00 | $496.00 |
| D5810 | $1,029.00 | $910.00 |
| D5811 | $1,043.00 | $922.00 |
| D5820 | $834.00 | $738.00 |
| D5821 | $834.00 | $738.00 |
| D5850 | $249.00 | $220.00 |
| D5851 | $249.00 | $220.00 |
| D5860 | $2,537.00 | $2,244.00 |
| D5861 | $2,477.00 | $2,191.00 |
| D5862 | $849.00 | $751.00 |
| D5867 | $462.00 | $409.00 |
| D5875 | $466.00 | $413.00 |
| D5937 | $882.00 | $780.00 |
| D5951 | $1,031.00 | $912.00 |
| D5982 | $529.00 | $468.00 |
| D5988 | $902.00 | $799.00 |
D6: implant services and fixed prosthodontics
85 rows| CDT | North | South |
|---|---|---|
| D6010 | $2,377.00 | $2,103.00 |
| D6012 | $1,872.00 | $1,656.00 |
| D6040 | $9,819.00 | $8,687.00 |
| D6050 | $6,885.00 | $6,091.00 |
| D6053 | $3,386.00 | $2,995.00 |
| D6054 | $3,321.00 | $2,938.00 |
| D6055 | $3,506.00 | $3,102.00 |
| D6056 | $962.00 | $851.00 |
| D6057 | $1,132.00 | $1,002.00 |
| D6058 | $1,727.00 | $1,528.00 |
| D6059 | $1,734.00 | $1,534.00 |
| D6060 | $1,626.00 | $1,438.00 |
| D6061 | $1,622.00 | $1,435.00 |
| D6062 | $1,698.00 | $1,502.00 |
| D6063 | $1,586.00 | $1,403.00 |
| D6064 | $1,623.00 | $1,436.00 |
| D6065 | $1,824.00 | $1,613.00 |
| D6066 | $1,838.00 | $1,626.00 |
| D6067 | $1,855.00 | $1,641.00 |
| D6068 | $1,731.00 | $1,531.00 |
| D6069 | $1,729.00 | $1,529.00 |
| D6070 | $1,641.00 | $1,452.00 |
| D6071 | $1,643.00 | $1,453.00 |
| D6072 | $1,741.00 | $1,540.00 |
| D6073 | $1,635.00 | $1,446.00 |
| D6074 | $1,603.00 | $1,418.00 |
| D6075 | $1,813.00 | $1,604.00 |
| D6076 | $1,854.00 | $1,640.00 |
| D6077 | $1,870.00 | $1,654.00 |
| D6078 | $6,621.00 | $5,858.00 |
| D6079 | $4,784.00 | $4,232.00 |
| D6080 | $375.00 | $331.00 |
| D6090 | $889.00 | $786.00 |
| D6091 | $752.00 | $665.00 |
| D6092 | $189.00 | $167.00 |
| D6093 | $216.00 | $191.00 |
| D6094 | $1,590.00 | $1,407.00 |
| D6095 | $863.00 | $763.00 |
| D6100 | $904.00 | $800.00 |
| D6190 | $509.00 | $451.00 |
| D6194 | $1,721.00 | $1,522.00 |
| D6205 | $1,156.00 | $1,023.00 |
| D6210 | $1,296.00 | $1,147.00 |
| D6211 | $1,201.00 | $1,063.00 |
| D6212 | $1,233.00 | $1,091.00 |
| D6214 | $1,292.00 | $1,143.00 |
| D6240 | $1,319.00 | $1,167.00 |
| D6241 | $1,215.00 | $1,075.00 |
| D6242 | $1,245.00 | $1,102.00 |
| D6245 | $1,358.00 | $1,202.00 |
| D6250 | $1,255.00 | $1,111.00 |
| D6251 | $1,244.00 | $1,101.00 |
| D6252 | $1,228.00 | $1,087.00 |
| D6253 | $910.00 | $805.00 |
| D6545 | $1,019.00 | $901.00 |
| D6548 | $1,122.00 | $992.00 |
| D6710 | $1,192.00 | $1,055.00 |
| D6720 | $1,253.00 | $1,109.00 |
| D6721 | $1,242.00 | $1,099.00 |
| D6722 | $1,245.00 | $1,102.00 |
| D6740 | $1,364.00 | $1,207.00 |
| D6750 | $1,330.00 | $1,177.00 |
| D6751 | $1,217.00 | $1,077.00 |
| D6752 | $1,245.00 | $1,102.00 |
| D6780 | $1,271.00 | $1,125.00 |
| D6781 | $1,218.00 | $1,078.00 |
| D6782 | $1,245.00 | $1,102.00 |
| D6783 | $1,296.00 | $1,147.00 |
| D6790 | $1,298.00 | $1,149.00 |
| D6791 | $1,201.00 | $1,063.00 |
| D6792 | $1,233.00 | $1,091.00 |
| D6793 | $661.00 | $585.00 |
| D6794 | $1,250.00 | $1,106.00 |
| D6920 | $1,182.00 | $1,046.00 |
| D6930 | $205.00 | $181.00 |
| D6940 | $528.00 | $467.00 |
| D6950 | $789.00 | $698.00 |
| D6970 | $517.00 | $458.00 |
| D6972 | $406.00 | $360.00 |
| D6973 | $323.00 | $285.00 |
| D6975 | $832.00 | $736.00 |
| D6976 | $343.00 | $303.00 |
| D6977 | $246.00 | $217.00 |
| D6980 | $455.00 | $403.00 |
| D6985 | $1,073.00 | $949.00 |
D7: oral and maxillofacial surgery
42 rows| CDT | North | South |
|---|---|---|
| D7110 | n/a | n/a |
| D7111 | $161.00 | $142.00 |
| D7120 | n/a | n/a |
| D7140 | $209.00 | $185.00 |
| D7210 | $328.00 | $290.00 |
| D7250 | $370.00 | $327.00 |
| D7290 | $625.00 | $553.00 |
| D7560 | $1,681.00 | $1,487.00 |
| D7610 | $5,162.00 | $4,567.00 |
| D7620 | $4,180.00 | $3,699.00 |
| D7630 | $5,349.00 | $4,732.00 |
| D7640 | $4,157.00 | $3,678.00 |
| D7650 | $4,631.00 | $4,097.00 |
| D7660 | $3,862.00 | $3,417.00 |
| D7670 | $2,257.00 | $1,997.00 |
| D7671 | $1,512.00 | $1,338.00 |
| D7680 | $7,759.00 | $6,864.00 |
| D7710 | $5,260.00 | $4,654.00 |
| D7720 | $4,133.00 | $3,656.00 |
| D7730 | $5,746.00 | $5,084.00 |
| D7740 | $4,273.00 | $3,781.00 |
| D7750 | $5,014.00 | $4,436.00 |
| D7760 | $7,186.00 | $6,358.00 |
| D7770 | $3,294.00 | $2,914.00 |
| D7771 | $2,287.00 | $2,023.00 |
| D7780 | $10,128.00 | $8,960.00 |
| D7810 | $5,014.00 | $4,436.00 |
| D7820 | $763.00 | $675.00 |
| D7830 | $1,166.00 | $1,032.00 |
| D7840 | $6,424.00 | $5,684.00 |
| D7850 | $6,210.00 | $5,494.00 |
| D7852 | $6,609.00 | $5,847.00 |
| D7854 | $6,140.00 | $5,432.00 |
| D7856 | $4,188.00 | $3,706.00 |
| D7880 | $1,453.00 | $1,376.00 |
| D7910 | $368.00 | $325.00 |
| D7911 | $610.00 | $540.00 |
| D7912 | $961.00 | $850.00 |
| D7920 | $3,110.00 | $2,751.00 |
| D7955 | $4,554.00 | $3,941.00 |
| D7960 | $538.00 | $476.00 |
| D7990 | $1,715.00 | $1,517.00 |
D8: orthodontics
5 rows| CDT | North | South |
|---|---|---|
| D8210 | $1,034.00 | $914.00 |
| D8220 | $1,174.00 | $1,039.00 |
| D8691 | $255.00 | $225.00 |
| D8692 | $405.00 | $359.00 |
| D8693 | $408.00 | $361.00 |
D9: adjunctive general services
22 rows| CDT | North | South |
|---|---|---|
| D9110 | $154.00 | $136.00 |
| D9210 | $91.00 | $80.00 |
| D9211 | $113.00 | $100.00 |
| D9212 | $317.00 | $280.00 |
| D9215 | $79.00 | $70.00 |
| D9220 | $480.00 | $425.00 |
| D9221 | $205.00 | $181.00 |
| D9230 | $96.00 | $85.00 |
| D9241 | $509.00 | $451.00 |
| D9242 | $200.00 | $177.00 |
| D9248 | $400.00 | $354.00 |
| D9310 | $158.00 | $140.00 |
| D9410 | $301.00 | $266.00 |
| D9420 | $357.00 | $315.00 |
| D9430 | $94.00 | $83.00 |
| D9610 | $131.00 | $116.00 |
| D9612 | $226.00 | $200.00 |
| D9630 | $63.00 | $56.00 |
| D9940 | $727.00 | $643.00 |
| D9950 | $418.00 | $370.00 |
| D9951 | $223.00 | $197.00 |
| D9952 | $846.00 | $748.00 |
Source
- The schedule: N.J.A.C. 11:3-29 Appendix, Exhibit 2, published by the New Jersey Department of Banking and Insurance and effective for treatment rendered on or after January 4, 2013. It has not been amended since.
- Official files: the Department’s auto medical fee schedule page, the rule text and the Department’s own FAQ.
- This page: parsed from the Department’s Excel file, with every row count and every figure cross-checked against the Department’s PDF of the same exhibit. Free to download as one CSV of all seven exhibits, 7,553 rows, no sign-up.
What the rule says about this schedule
What does Exhibit 2 cover?
The ten CDT categories, from diagnostic through adjunctive general services. The largest blocks are implant and fixed prosthodontic services with 85 codes, restorative with 75, removable prosthodontics with 45 and oral and maxillofacial surgery with 42. Orthodontics is the smallest at five.
The schedule prices the treatment, not the cause. Nothing on Exhibit 2 decides whether a particular crown or extraction was necessitated by the accident, which is a medical necessity question under 11:3-29.2 and 11:3-4, answered separately from the fee.
Why are two dental codes printed n/a?
D7110 and D7120, the old simple extraction codes, carry the letters n/a in both fee columns. That is what the State printed, and it is deliberate: CDT superseded both, and their replacement sits two rows below them on the same page. D7140, extraction of an erupted tooth or exposed root, is $209 in the North and $185 in the South.
The distinction matters when reading this page against a bill. An n/a cell is the schedule saying there is no fee for this code. An empty cell elsewhere on the seven exhibits means something different in each column, and neither is the same as a code being absent from the schedule entirely, which 11:3-29.4(e) prices as a usual and customary claim.
Does the $105 daily maximum apply to a dentist?
Yes, and the rule says so in those words. 11:3-29.4(m) states that the daily maximum applies to all providers, including dentists. The $105 ceiling on the Exhibit 6 physical medicine and rehabilitation codes is not limited to physical therapists, chiropractors or physicians.
It applies to the codes on Exhibit 6, not to dental treatment generally, so an extraction priced on this page is unaffected. Where a dental practice bills one of the 48 codes on Exhibit 6 on the same day another provider billed one, both fall inside the same $105.
Which region prices a dental bill?
The region where the treatment was given. 11:3-29.4(b) picks the fee by where the service was rendered, and 11:3-29.3(a) names Exhibit 2 among the schedules those regions govern. A patient's home address does not choose the column.
The one case where residence does decide is elective care outside New Jersey. 11:3-29.4(d)2 prices an elective out-of-state service under the schedule for the region where the insured lives. Where the out-of-state care was an emergency or medically necessary rather than elective, 29.4(d)1 uses the usual and customary fee for that provider's own location instead.