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    OpenPayerBilling CodesD1110-prophylaxis-adult-cleaning-and-polishing-of-the
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    CDT D1110: Prophylaxis - Adult; Cleaning and Polishing of the Teeth

    Headline: CDT code D1110: Adult Prophylaxis — routine professional teeth cleaning

    Lead: CDT code D1110 covers professional adult prophylaxis — cleaning and polishing of the teeth — a common preventive dental procedure with broad national relevance for routine oral health maintenance and preventive care access.

    What the code represents and why it matters: CDT code D1110 denotes an established preventive dental service aimed at removing plaque, calculus, and extrinsic stains to reduce risk of caries and periodontal disease. Nationally, this service is a frequent entry point for preventive dental benefit utilization and influences care patterns, utilization management, and preventive coverage policies across payers.

    Key payers covered: The analysis includes major national payers: Aetna; Blue Cross Blue Shield; Cigna Health; Medicare; and UnitedHealthcare. These payers collectively shape coverage norms and patient cost-sharing for routine dental prophylaxis.

    Overview of reader takeaways: Readers will find a concise clinical and billing description of CDT code D1110, comparisons to related preventive dental services, payer coverage context, common coding considerations, and typical sites of service. The content summarizes clinical intent, common diagnostic associations, and related codes that practitioners and billing professionals use alongside D1110.

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    Billing Code Overview

    CDT code D1110 represents prophylaxis for adults, specifically the professional service of cleaning and polishing the teeth. The procedure is delivered within the field of dentistry and is typically performed in a dental office (POS 11). This service focuses on removal of plaque, calculus, and stains to maintain oral health and prevent disease.

    National Reimbursement Benchmarks

    National mean rates show a clear gap between Medicare and the BUCA (average commercial) benchmark: Medicare has no localities reported in the input, so Data not available in the input., while BUCA (average commercial) reports a mean of $49.56. Among commercial payers, UnitedHealthcare ($68.51) and Blue Cross Blue Shield ($60.71) sit above the BUCA mean, while Aetna ($40.65) and Cigna Health ($36.58) sit below it.

    Dispersion measured as P75 minus P25 varies across payers. UnitedHealthcare has a relatively tight spread (75.13 - 62 = $13.13), Cigna Health is also tight (41 - 33 = $8.00), while Blue Cross Blue Shield shows a wider spread (71 - 46 = $25.00). Aetna's spread is $12.00 and BUCA's spread is $26.20. The table and chart below present the full breakdown.

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    National Mean Allowed Rates for CDT code D1110 by Payer

    Clinical & Coding Specifications

    Clinical Context

    An adult patient presents to a dental office (POS 11) for routine preventive care consisting of scaling, cleaning, and polishing of the teeth. The patient may be asymptomatic and seeking routine maintenance, or may have plaque/calculus or early signs of decay or periodontal inflammation identified on examination. The clinical workflow typically includes patient arrival and registration, medical history review, intraoral examination by the dentist or dental hygienist, prophylaxis treatment (removal of plaque and calculus, scaling and polishing), documentation of findings, and any preventive recommendations. Vital signs and informed consent for standard prophylaxis are recorded, and follow-up or adjunct procedures (for example, topical fluoride application or a comprehensive oral evaluation) are scheduled as clinically indicated.

    Related Codes

    • D1120 - Prophylaxis - child

    • Relation: Age-based counterpart to D1110; used instead of D1110 for pediatric patients and serves as an alternative based on patient age.

    • D1206 - Topical application of fluoride varnish

    • Relation: Adjunct preventive procedure often performed in the same visit after prophylaxis for additional caries prevention; commonly used together when clinically appropriate.

    • D1208 - Topical application of fluoride

    • Relation: Alternative topical fluoride application method to D1206; may be used instead of or in addition to prophylaxis-dependent preventive measures.

    • D0150 - Comprehensive oral evaluation - new or established patient

    • Relation: A diagnostic evaluation that may precede or accompany D1110 when a full assessment is required; can be used in the same visit when a comprehensive exam is performed prior to prophylaxis.

    Related Codes

    D2750-CROWN-PORCELAIN-FUSED-TO-HIGH-NOBLE

    D2750 – Crown - porcelain fused to high noble metal

    D2150-AMALGAM-TWO-SURFACES-PRIMARY-OR

    D2150 – Amalgam - two surfaces, primary or permanent

    D1208-TOPICAL-APPLICATION-OF-FLUORIDE-EXCLUDING

    D1208 – Topical application of fluoride - excluding varnish

    D2393-RESINBASED-COMPOSITE-THREE-SURFACES

    CPT D2393: Resin-Based Composite Restoration, Three Surfaces, Posterior

    D4910-PERIODONTAL-MAINTENANCE

    CPT D4910: Periodontal Maintenance Procedures

    D1206-TOPICAL-FLUORIDE-TREATMENT-EXCEPT-VARNISH-THERAPEUTIC

    CPT D1206: Topical Fluoride Treatment for Moderate to High Caries Risk Patients

    D1120-

    CPT D1120: Prophylaxis for Children, Preventive Dental Cleaning

    D2391-RESINBASED-COMPOSITE-ONE-SURFACE

    CPT D2391: Resin-Based Composite Restoration, One Surface, Posterior Tooth

    D1351-SEALANT-PER

    CPT D1351: Dental Sealant Application, Per Tooth

    D7210-EXTRACTION-ERUPTED-TOOTH-REQUIRING-REMOVAL-OF-BONE-ANDOR

    CPT D7210: Surgical Extraction of Erupted Tooth with Bone Removal

    Showing 1–10 of 24

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.