CDT D1351: Sealant - per tooth

CDT code D1351 denotes a per-tooth dental sealant procedure used to prevent occlusal caries by sealing pits and fissures on tooth surfaces. As a common preventive intervention in both pediatric and general dental practice, sealants play a significant role in reducing the incidence of dental caries and subsequent restorative needs nationwide. The code is widely used across dental practices and appears in commercial payer coverage policies and fee schedules.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise description of the clinical purpose of the procedure, common billing relationships with related preventive services, and insurer considerations that typically affect coverage and claims handling. The publication outlines typical sites of service and situates D1351 beside related preventive dental procedures such as topical fluoride applications and prophylaxis to clarify clinical context.

This summary equips billing staff, dental administrators, and policy analysts with an overview of where D1351 fits within preventive dentistry, common payer coverage expectations, and the types of documentation and coding relationships that frequently accompany sealant services. Data not available in the input is noted where applicable.

Customize your policy alerts

Sign up for D1351 policy alerts

Get alerted when payer policies referencing D1351 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

CDT code D1351 represents Sealant - per tooth, a preventive dental procedure involving the application of a protective resin material to the occlusal surfaces of a tooth to reduce the risk of dental caries. This procedure is categorized under Dentistry services.

Typical site of service: Dental Office (POS 11).

Data not available in the input.

National Reimbursement Benchmarks

National commercial mean rates for CDT code D1351 vary substantially: UnitedHealthcare and Blue Cross Blue Shield report the highest mean rates at $37.45 and $35.42 respectively, while Aetna and Cigna Health cluster near $19.50–$19.79. BUCA (average commercial) sits between commercial and the highest payers at $26.59. Medicare is not provided in the input, so a direct numeric comparison with Medicare is not available.

Rate dispersion (P75 minus P25) is widest for Blue Cross Blue Shield and UnitedHealthcare (both showing a 12.5 dollar interpercentile spread for UHC and 12.5 for BCBS), indicating greater variability in paid rates. BUCA shows a moderate spread of $15.50, while Aetna and Cigna Health are the tightest, with spreads of $4.00 and $4.00 respectively. The table and chart below present the full breakdown.

Explore openpayer tools

View all tools

CDT D1351: Sealant - per tooth

Customize your policy alerts

Sign up for D1351 policy alerts

Get alerted when payer policies referencing D1351 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Billing Code Overview

Typical site of service: Dental Office (POS 11).

Data not available in the input.

National Reimbursement Benchmarks

National Mean Rates for CDT code D1351 by Payer

Clinical & Coding Specifications

Clinical Context

A pediatric patient presents to a dental office (POS 11) for a routine preventive visit. The dentist performs an oral examination and determines a posterior molar has deep pits and fissures at elevated risk for occlusal caries but without cavitation, or the tooth has arrested caries amenable to sealing. After discussing the procedure with the parent and obtaining consent, the dentist performs prophylaxis as indicated, isolates and dries the tooth, applies an etchant if used by office protocol, and places a pit-and-fissure sealant on the affected tooth. The visit is documented with tooth number, surface, materials used, and rationale (preventive sealant for high caries risk or sealant placement over arrested caries). Billing is submitted using CDT code D1351 (Sealant - per tooth) with the appropriate modifier if services were reduced or repeated during the same encounter.

Related Codes

Code	Description	Relationship to `D1351`
`D1206`	Topical application of fluoride varnish	Often performed during the same preventive visit; topical fluoride is complementary to sealants for caries prevention and may be billed separately when criteria for both are met.
`D1208`	Topical application of fluoride	Alternative topical fluoride application commonly provided in preventive visits; may be used in lieu of or in addition to `D1206` depending on material and protocol.
`D1120`	Prophylaxis - child	Commonly performed immediately prior to sealant placement to remove plaque and improve retention; often billed in the same visit when indicated.
`D1110`	Prophylaxis - adult	Same relation as `D1120` but for adult patients; used when sealant placement occurs in adult preventive care scenarios.

Common co‑usage: D1351 is frequently performed alongside D1120 or D1110 (prophylaxis) and may be billed with topical fluoride codes (D1206 or D1208) when documentation supports distinct services. Modifiers such as 52 or 76 are applied to D1351 as described in Coding Specifications when warranted.

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

D4910-PERIODONTAL-MAINTENANCE

CPT D4910: Periodontal Maintenance Procedures

D1110-PROPHYLAXIS-ADULT-CLEANING-AND-POLISHING-OF-THE

CPT D1110: Adult Dental Cleaning and Polishing

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

D0140-LIMITED-ORAL-EVALUATION-PROBLEM

CPT D0140: Limited Oral Evaluation, Problem Focused

D2790-CROWN-FULL-CAST-HIGH-NOBLE

CPT D2790: Full Cast High Noble Metal Crown Placement

D2330-RESINBASED-COMPOSITE-ONE-SURFACE

CPT D2330: Resin-Based Composite Restoration, One Surface, Anterior

D2140-AMALGAM-ONE-SURFACE-PRIMARY-OR

CPT D2140: Amalgam Restoration, One Surface, Primary or Permanent Tooth

D2160-AMALGAM-THREE-SURFACES-PRIMARY-OR

CPT D2160: Amalgam Filling, Three Surfaces, Primary or Permanent Tooth

Showing 1–10 of 24

References

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.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.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.

Published by

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.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related Codes

Code	Description	Relationship to `D1351`
`D1206`	Topical application of fluoride varnish	Often performed during the same preventive visit; topical fluoride is complementary to sealants for caries prevention and may be billed separately when criteria for both are met.
`D1208`	Topical application of fluoride	Alternative topical fluoride application commonly provided in preventive visits; may be used in lieu of or in addition to `D1206` depending on material and protocol.
`D1120`	Prophylaxis - child	Commonly performed immediately prior to sealant placement to remove plaque and improve retention; often billed in the same visit when indicated.
`D1110`	Prophylaxis - adult	Same relation as `D1120` but for adult patients; used when sealant placement occurs in adult preventive care scenarios.

Common co‑usage: D1351 is frequently performed alongside D1120 or D1110 (prophylaxis) and may be billed with topical fluoride codes (D1206 or D1208) when documentation supports distinct services. Modifiers such as 52 or 76 are applied to D1351 as described in Coding Specifications when warranted.

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

D4910-PERIODONTAL-MAINTENANCE

CPT D4910: Periodontal Maintenance Procedures

D1110-PROPHYLAXIS-ADULT-CLEANING-AND-POLISHING-OF-THE

CPT D1110: Adult Dental Cleaning and Polishing

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

D0140-LIMITED-ORAL-EVALUATION-PROBLEM

CPT D0140: Limited Oral Evaluation, Problem Focused

D2790-CROWN-FULL-CAST-HIGH-NOBLE

CPT D2790: Full Cast High Noble Metal Crown Placement

D2330-RESINBASED-COMPOSITE-ONE-SURFACE

CPT D2330: Resin-Based Composite Restoration, One Surface, Anterior

D2140-AMALGAM-ONE-SURFACE-PRIMARY-OR

CPT D2140: Amalgam Restoration, One Surface, Primary or Permanent Tooth

D2160-AMALGAM-THREE-SURFACES-PRIMARY-OR

CPT D2160: Amalgam Filling, Three Surfaces, Primary or Permanent Tooth

Showing 1–10 of 24

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.