72801 First tooth
| 70000 | ORAL MAXILLOFACIAL SURGERY |
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| 72000 | REMOVALS, (EXTRACTIONS), SURGICAL |
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| 72800 | REMOVAL OF FRACTURED CUSP AS A SEPARATE PROCEDURE, NOT IN CONJUCTION WITH SURGICAL |
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| 72801 | First tooth | $84.27 | $84.27 |