New 2026 - Page 3

IMPLANT SERVICES | OTHER IMPLANT SERVICES | January 1, 2026

SCALING AND DEBRIDEMENT OF A SINGLE IMPLANT IN THE PRESENCE OF PERI-IMPLANTITIS INFLAMMATION, BLEEDING UPON PROBING AND INCREASED POCKET DEPTHS, INCLUDING CLEANING OF THE IMPLANT SURFACES, WITHOUT FLAP ENTRY AND CLOSURE

ADJUNCTIVE GENERAL SERVICES | ANESTHESIA | January 1, 2026

ADMINISTRATION OF GENERAL ANESTHESIA WITH ADVANCED AIRWAY – FIRST 15 MINUTE INCREMENT, OR ANY PORTION THEREOF

IMPLANT SERVICES | OTHER IMPLANT SERVICES | January 1, 2026

REMOVAL OF AN INDIRECT RESTORATION ON AN IMPLANT RETAINED ABUTMENT

ADJUNCTIVE GENERAL SERVICES | ANESTHESIA | January 1, 2026

ADMINISTRATION OF MODERATE SEDATION – ENTERAL

ADJUNCTIVE GENERAL SERVICES | ANESTHESIA | January 1, 2026

ADMINISTRATION OF MODERATE SEDATION – NON-INTRAVENOUS PARENTERAL – EACH SUBSEQUENT 15 MINUTE INCREMENT, OR ANY PORTION THEREOF