COVERAGE · VIRGINIASHEET 47 / 51

Virginia, measured.

10,890 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 July 1, 2024 (view the source document). Practice costs index at 0.981 against the 1.000 national baseline.

EFFECTIVE JULY 1, 2024 · FLOORS 24 OF 25 CODES Official schedule on file
10,890Licensed providers
24Medicaid fee rows
0.981Geo cost index / 1.000
$26.99 to $1,408.63Floor range
FEE SPECTRUM25 BENCHMARK CDT CODES

The Virginia fee table

ProcedureMedicaid floorInsurer typicalPrivate-pay p50Private-pay p90
Diagnostic
Routine checkup (existing patient)$26.99$42$59$91
Comprehensive exam (new patient)$41.92$71$98$152
Full-mouth X-ray series$96.28$113$157$228
Bitewing X-rays (set of 4)$36.96$50$69$100
Panoramic X-ray$72.30$99$137$199
Emergency
Emergency visit for pain relief$64.85$102$142$220
Endodontics
Root canal, front tooth$502.13$671$932$1,445
Root canal, molar$909.18$904$1,256$1,947
Implants
Dental implant placementNo published floor$1,448$2,011$3,117
Oral surgery
Simple tooth extraction$92.39$138$191$296
Surgical tooth extraction$171.39$233$324$502
Orthodontics
Full braces treatment, adolescent$1,408.63$4,026$5,592$7,549
Periodontics
Deep cleaning below gumline (per quadrant)$124.71$180$250$388
Ongoing gum maintenance visit$83.14$113$157$243
Preventive
Adult teeth cleaning$63.19$74$103$160
Child teeth cleaning$44.89$56$78$121
Fluoride varnish treatment$27.84$35$49$76
Protective tooth sealant$43.22$39$54$84
Restorative
Metal filling (1 surface)$79.51$109$152$236
Tooth-colored filling, front tooth$99.46$138$191$296
Tooth-colored filling, back tooth (1 surface)$99.46$148$206$319
Tooth-colored filling, back tooth (2 surfaces)$119.41$176$245$380
Ceramic crown$669.50$989$1,373$2,128
Porcelain-on-metal crown$669.50$812$1,128$1,748
Crown foundation buildup$147.65$212$294$456

Floor. Official Virginia Medicaid fee-for-service dental schedule, effective July 1, 2024. View the source document.

Bands. Modeled: the national median billed charge for each procedure, scaled by the Virginia geographic cost index (0.981 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
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