Dental Item Numbers: Check Your Claim
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Townsville Dental Directory editorial team
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Updated 19 May 2026
dental item numbersADA codesdental costshealth insurancedental claims
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In This Guide
What Dental Item Numbers Should I Check on Your Claim?
Every dental invoice in Australia lists standardised item numbers that describe the procedures you received. These codes are published in the Australian Schedule of Dental Services and Glossary, maintained by the Australian Dental Association, and are used nationally by all dental practitioners and health funds (ADA, Australian Schedule of Dental Services and Glossary, 12th edition). Understanding these numbers helps you verify that your invoice is accurate, check your health fund rebate before treatment, and compare quotes between providers.
At Townsville Dental Clinic, we provide itemised treatment plans with full ADA item numbers so you can confirm your expected rebate before any work begins.
How the ADA Item Number System Works
The ADA item number system divides dental procedures into categories based on the type of treatment. Each item has a three-digit code (or four digits for newer items) and a written description. The main categories are:
| Item Range | Category | Examples |
|---|---|---|
| 011–099 | Diagnostic | Examinations, X-rays, consultations |
| 111–199 | Preventive | Scale and clean, fluoride, fissure sealants |
| 211–299 | Periodontics | Gum treatment, deep cleaning |
| 311–399 | Oral surgery | Extractions, surgical removal |
| 411–499 | Endodontics | Root canal therapy |
| 511–599 | Restorative | Fillings |
| 611–699 | Prosthodontics (fixed) | Crowns, bridges, implants |
| 711–799 | Prosthodontics (removable) | Dentures |
| 811–899 | Orthodontics | Braces, aligners |
Common Item Numbers Explained
Diagnostic Items
| Item | Description | Typical Fee | Typical Rebate |
|---|---|---|---|
| 011 | Comprehensive oral examination | $60–$90 | $30–$60 |
| 012 | Periodic oral examination | $50–$70 | $25–$50 |
| 013 | Oral examination — limited | $40–$60 | $20–$40 |
| 022 | Intraoral periapical X-ray | $35–$55 | $15–$35 |
| 037 | Panoramic X-ray (OPG) | $100–$160 | $50–$100 |
Preventive Items
| Item | Description | Typical Fee | Typical Rebate |
|---|---|---|---|
| 114 | Removal of calculus (scale and clean) | $120–$200 | $50–$100 |
| 115 | Removal of plaque and stain | $80–$130 | $40–$70 |
| 121 | Topical fluoride application | $30–$50 | $15–$30 |
| 161 | Fissure sealant — per tooth | $40–$70 | $20–$40 |
Oral Surgery Items
| Item | Description | Typical Fee | Typical Rebate |
|---|---|---|---|
| 311 | Extraction — single tooth | $180–$300 | $80–$160 |
| 314 | Sectional removal of tooth | $280–$450 | $120–$250 |
| 324 | Surgical removal — soft tissue impaction | $350–$550 | $150–$300 |
Endodontic Items
| Item | Description | Typical Fee | Typical Rebate |
|---|---|---|---|
| 415 | Root canal — single canal | $800–$1,200 | $300–$550 |
| 416 | Root canal — each additional canal | $200–$400 | $80–$200 |
Restorative and Prosthodontic Items
| Item | Description | Typical Fee | Typical Rebate |
|---|---|---|---|
| 521–535 | Fillings (vary by size and surfaces) | $150–$400 | $60–$200 |
| 613 | Full crown — porcelain | $1,500–$2,200 | $300–$800 |
| 615 | Full crown — porcelain fused to metal | $1,400–$2,000 | $300–$750 |
| 661 | Implant fixture placement | $2,500–$3,500 | $500–$1,200 |
How to Check Your Rebate Before Treatment
- Ask your dentist for an itemised treatment plan — with ADA item numbers and fees
- Log in to your health fund portal — use the benefit estimator tool
- Enter each item number and fee — the system will show your estimated rebate and gap
- Request a written pre-treatment estimate — your fund will confirm benefits in writing
- Check your remaining annual limit — ensure you have sufficient benefit available
Why Fees Differ from Rebates
Dental fees are determined by each practice individually. Your health fund calculates rebates based on its own benefit schedule, which is typically lower than the dentist’s actual fee. The resulting gap payment is your out-of-pocket cost.
Visiting a preferred provider may reduce your gap, as some funds negotiate set fees for common items with participating practices.
Related Services
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Frequently Asked Questions
What are dental item numbers in Australia?
Dental item numbers are standardised codes assigned by the Australian Dental Association to every dental procedure. Each code corresponds to a specific treatment — for example, item 011 is a comprehensive oral examination and item 114 is a removal of calculus (scale and clean). These codes appear on your dental invoice and are used by health funds to calculate your rebate. The full schedule is published in the Australian Schedule of Dental Services and Glossary.
What does dental item number 011 mean?
Item 011 is the code for a comprehensive oral examination. This is typically the examination you receive at your first visit to a new dentist or when a full assessment of your oral health is required. It includes a clinical examination of all teeth, gums, and soft tissues, and usually forms the basis of your treatment plan. Health fund rebates for item 011 typically range from $30 to $60.
What is dental item number 114?
Item 114 refers to the removal of calculus — commonly known as a scale and clean. This procedure involves the removal of hardened plaque (tartar) from above and below the gumline using ultrasonic and hand instruments. It is one of the most frequently claimed dental items. Health fund rebates for item 114 typically range from $50 to $100, depending on your policy.
How do I check my rebate for a dental item number?
You can check your expected rebate by logging into your health fund's member portal or app and searching the item number. Most funds provide an online benefit estimator where you enter the item number and fee to see the estimated rebate and gap payment. Alternatively, call your fund's customer service line with the item numbers from your treatment plan or invoice. Your dentist can also request a pre-treatment estimate from your fund.
Why does my dentist charge more than my health fund rebate?
Dental fees are set by each individual practice and are not regulated by health funds. Your health fund sets a benefit amount for each item number based on its own fee schedule, which may be lower than your dentist's actual fee. The difference between the fee charged and the rebate paid is called the gap, and you are responsible for paying this amount. Preferred provider arrangements can reduce or eliminate the gap for selected items.
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