COVERAGE · NEW YORKSHEET 33 / 51

New York, measured.

24,324 licensed dental providers on record, refreshed monthly from the federal registry. The Medicaid floors below come from the official state fee-for-service schedule, effective January 1, 2026 (view the source document). Practice costs index at 1.091 against the 1.000 national baseline.

EFFECTIVE JANUARY 1, 2026 · FLOORS 24 OF 25 CODES Official schedule on file
24,324Licensed providers
24Medicaid fee rows
1.091Geo cost index / 1.000
$24.24 to $1,010Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The New York fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$25.25$47$65$101
Comprehensive exam (new patient)$30.30$78$109$169
Full-mouth X-ray series$50.50$126$175$254
Bitewing X-rays (set of 4)$24.24$55$76$110
Panoramic X-ray$35.35$110$153$222
Emergency
Emergency visit for pain relief$25.25$114$158$245
Endodontics
Root canal, front tooth$252.50$746$1,036$1,606
Root canal, molar$404$1,005$1,396$2,164
Implants
Dental implant placement$1,010$1,611$2,237$3,467
Oral surgery
Simple tooth extraction$50.50$153$213$330
Surgical tooth extraction$85.85$259$360$558
Orthodontics
Full braces treatment, adolescent$995.86$4,478$6,219$8,396
Periodontics
Deep cleaning below gumline (per quadrant)$45.45$200$278$431
Ongoing gum maintenance visit$45.45$126$175$271
Preventive
Adult teeth cleaning$45.45$83$115$178
Child teeth cleaning$43.43$63$87$135
Fluoride varnish treatment$30.30$40$55$85
Protective tooth sealant$35.35$43$60$93
Restorative
Metal filling (1 surface)$50.50$122$169$262
Tooth-colored filling, front tooth$50.50$153$213$330
Tooth-colored filling, back tooth (1 surface)$50.50$165$229$355
Tooth-colored filling, back tooth (2 surfaces)$67.67$197$273$423
Ceramic crown$505$1,099$1,527$2,367
Porcelain-on-metal crown$505$904$1,255$1,945
Crown foundation buildupNo published floor$235$327$507

Floor. Official New York Medicaid fee-for-service dental schedule, effective January 1, 2026. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the New York geographic cost index (1.091 against a 1.000 national baseline), with the insurer-typical amount modeled at roughly 72 percent of area billed charges. Estimates, not quotes.

HOW TO READ IT

Reading this table

The Medicaid floor is the exact fee on the state schedule: the lowest rate a practice accepts for that procedure, and the anchor of the revenue spectrum. Insurer typical models what a commercial plan tends to allow, about 72 percent of area billed charges. Private-pay p50 and p90 are modeled billed-charge bands: the national median scaled by the state cost index, and the top of the usual range. Where a practice actually lands depends on its payer mix. The floor is owned data; the bands are estimates.

CROSS REFERENCE
Explore any market anywhere in New York. Three free explorations a day, no card. An exploration runs in 60 to 90 seconds: competition, demand, referral network, and every figure against its benchmark.