Billing Code Overview

CDT code D2790 represents a full cast crown fabricated from high noble metal used in restorative dentistry to restore a damaged or decayed tooth. The service is classified as a restorative dental procedure performed to reestablish tooth form, function, and occlusal relationships when a full-coverage crown is indicated.

Typical site of service: Dental office (non‑facility).

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Clinical Context

A 56-year-old patient presents to a dental office with a fractured posterior tooth and extensive coronal destruction from chronic caries and previous restorations. Clinical assessment and radiographs reveal insufficient tooth structure to support a direct restoration and the need for full coverage. Treatment planning includes crown preparation, fabrication of a laboratory-fabricated full cast high noble metal crown, and cementation at a subsequent visit. Pulp status is evaluated; if endodontic therapy or post/core is required, those procedures are documented separately. Typical workflow: diagnosis and treatment planning visit with radiographs and bite records, tooth preparation appointment, impression and provisional crown fabrication, laboratory fabrication of the full cast high noble metal crown, and final cementation appointment in the dental office (non‑facility). Documentation includes informed consent, preoperative and postoperative photographs or radiographs, tooth-specific charting, materials used, and any adjunctive procedures such as core buildup or post placement when performed.

Coding Specifications

• CDT code D2790 — Crown – full cast high noble metal (restorative dental procedure).

• Common Modifiers

• 22 — Increased Procedural Services: Used when work required to perform the service is substantially greater than typically required. Documentation must describe the unusual circumstances and justify the additional work relative to a standard D2790 case.

• 52 — Reduced Services: Used when the service performed is partially reduced or eliminated at the physician or dentist’s discretion. Documentation must indicate which portion of the procedure was reduced or omitted and why.

• Associated Provider Taxonomies

• 1223G0001X — General Practice Dentist: Represents dentists providing general restorative and prosthodontic services, including crown preparations and placements.

• 1223P0700X — Prosthodontics Dentist: Represents specialists in prosthodontics who plan and restore complex crown and fixed prosthetic restorations, including selection of high noble metal alloys.

• 1223D0001X — Dentist: General dentist taxonomy broadly representing licensed dentists who may perform restorative crown procedures.

Related Diagnoses

• K08.5 — Residual dental roots

  Clinical relevance: Residual roots indicate previous tooth structure loss; may necessitate extraction or preparation for prosthetic restoration such as a crown if root structure is restorable prior to D2790 consideration.

• K02.9 — Dental caries, unspecified

  Clinical relevance: Extensive caries can destroy coronal tooth structure, leading to the need for full coverage restoration like a D2790 crown after caries removal and appropriate buildup.

• K03.6 — Deposits [accretions] on teeth

  Clinical relevance: Calculus or accretions may contribute to periodontal compromise; thorough debridement is often required before definitive restorative treatment such as D2790.

• K04.7 — Periapical abscess without sinus

  Clinical relevance: Periapical pathology may require endodontic therapy prior to crown placement; following resolution and possible post/core procedures, a D2790 crown may be placed.

• K08.8 — Other specified disorders of teeth and supporting structures

  Clinical relevance: Other structural or supporting conditions may affect prognosis and treatment planning for a full cast high noble metal crown like D2790.

Related Codes

• D2920 — Recement crown

  Relation: Used when an existing crown becomes loose; distinct from fabrication of a new D2790. May occur after initial cementation if retention issues arise.

• D2930 — Prefabricated stainless steel crown‑primary tooth

  Relation: Alternative full coverage option for primary teeth; not a substitute for D2790, which is a full cast high noble metal crown for permanent dentition.

• D2931 — Prefabricated stainless steel crown‑permanent teeth

  Relation: Prefabricated option for permanent teeth; used in different clinical situations compared with laboratory-fabricated D2790 crowns.

• D2932 — Prefabricated resin crown

  Relation: Chairside prefabricated restorative alternative; differs in materials and indications from D2790.

• D2933 — Prefabricated stainless steel crown with resin window

  Relation: Prefabricated aesthetic variant; alternative to a custom D2790 crown when appropriate.

• D2940 — Protective restoration

  Relation: Temporary measure to protect a tooth until definitive crown treatment like D2790 can be completed.

• D2950 — Core buildup, including any pins when required

  Relation: Often performed prior to crown preparation when substantial coronal tooth structure is missing; may be required before D2790 placement.

• D2951 — Pin retention‑ per tooth, in addition to restoration

  Relation: Ancillary service used during core buildup to retain restorative material prior to crown fabrication like D2790.

• D2952 — Post and core in addition to crown, indirectly fabricated

  Relation: When endodontic therapy leaves insufficient coronal structure, an indirect post and core may be fabricated prior to placing a D2790 crown.

• D2954 — Prefabricated post and core in addition to crown

  Relation: Prefabricated post/core option used in the workflow before final D2790 crown placement.

• D2960 — Labial veneer (resin laminate)‑ Chair side

  Relation: Veneer procedures are restorative alternatives for anterior aesthetics; not typically combined with D2790 which is a full cast crown.

• D2980 — Crown repair necessitated by restorative material failure

  Relation: Used when an existing crown fails and repair is feasible; if irreparable, replacement with a new D2790 may be indicated.

• D2981 — Inlay repair necessitated by restorative material failure

  Relation: Repair of inlays; separate from full crown services like D2790.

• D2982 — Onlay repair necessitated by restorative material failure

  Relation: Onlay repairs are restorative alternatives or interim treatments relative to full coverage crowns such as D2790.

• D2983 — Veneer repair necessitated by restorative material failure

  Relation: Repair of veneer restorations; not directly combined with D2790.

• D2999 — Unspecified restorative procedure, by report

  Relation: Used when a restorative service does not fall under a specific code; documentation and narrative are required if billing instead of D2790.

• D3220 — Therapeutic pulpotomy

  Relation: Pulp therapy that may be performed prior to core buildup and subsequent crown placement with D2790 if pulpal involvement is present.

National mean commercial rates for CDT code D2790 vary substantially versus the BUCA average and Medicare. BUCA (average commercial) posts a mean of $571.17, which is higher than Aetna ($423.47) and Cigna Health ($431.92) but lower than Blue Cross Blue Shield ($759.42) and UnitedHealthcare ($773.81). Medicare is not provided in the input and is represented separately in the chart and table.

Rate dispersion (interquartile range, P75 − P25) is widest for Blue Cross Blue Shield (range $260.00) and UnitedHealthcare (range $142.97), indicating broader variability at the national level. Cigna Health shows one of the tightest distributions (range $107.00) and Aetna is relatively tight as well (range $70.00). The table and chart below present the full breakdown.