| Code | Display | Definition |
| 00121C |
牙醫門診診察費-每日≤20人-處方交付特約藥局 |
Dental clinic visit fee - prescription to pharmacy - 20 or fewer patients per day |
| 00122C |
牙醫門診診察費-每日≤20人-未處方或自行調劑 |
Dental clinic visit fee - no prescription or in-house dispensing - 20 or fewer patients per day |
| 00123C |
牙醫門診診察費-每日>20人-處方交付特約藥局 |
Dental clinic visit fee - prescription to pharmacy - more than 20 patients per day |
| 00124C |
牙醫門診診察費-每日>20人-未處方或自行調劑 |
Dental clinic visit fee - no prescription or in-house dispensing - more than 20 patients per day |
| 00125C |
牙醫門診診察費-山地離島-處方交付特約藥局 |
Dental clinic visit fee - remote areas - prescription to pharmacy |
| 00126C |
牙醫門診診察費-山地離島-未處方或自行調劑 |
Dental clinic visit fee - remote areas - no prescription or in-house dispensing |
| 00128C |
自閉症、失智症及重度以上身心障礙者診察費 |
Diagnosis fee for autism, dementia, severe disability patients |
| 00301C |
中度身心障礙者(非精神科)診察費 |
Diagnosis fee for moderate disability patients (non-psychiatric) |
| 00302C |
中度以上精神病患診察費 |
Diagnosis fee for moderate+ mental illness patients |
| 00303C |
輕度身心障礙者/身障老人診察費 |
Diagnosis fee for mild disability/disabled elderly |
| 00304C |
身心障礙者轉診費 |
Referral fee for disability patients to special services |
| 01271C |
全口X光檢查 |
Panoramic radiograph examination |
| 01272C |
年度X光檢查 |
Annual radiograph examination |
| 01273C |
高齲齒族群年度X光檢查 |
Annual radiograph for high-cavity-risk populations |
| 00305C |
加強感染管制門診診察費-≤20人-藥局 |
Enhanced infection control clinic visit fee - 20 or fewer - pharmacy |
| 00306C |
加強感染管制門診診察費-≤20人-無藥局 |
Enhanced infection control clinic visit fee - 20 or fewer - no pharmacy |
| 00307C |
加強感染管制門診診察費->20人-藥局 |
Enhanced infection control clinic visit fee - over 20 - pharmacy |
| 00308C |
加強感染管制門診診察費->20人-無藥局 |
Enhanced infection control clinic visit fee - over 20 - no pharmacy |
| 00309C |
加強感染管制山地離島診察費-藥局 |
Enhanced infection control remote area visit - pharmacy |
| 00310C |
加強感染管制山地離島診察費-無藥局 |
Enhanced infection control remote area visit - no pharmacy |
| 00311C |
加強感染管制重度身障診察費 |
Enhanced infection control fee - severe disability |
| 00312C |
加強感染管制中度身障診察費 |
Enhanced infection control fee - moderate disability |
| 00313C |
加強感染管制中度以上精神病患診察費 |
Enhanced infection control fee - moderate+ mental illness |
| 00314C |
加強感染管制輕度身障/身障老人診察費 |
Enhanced infection control fee - mild disability/disabled elderly |
| 00315C |
加強感染管制全口X光檢查 |
Enhanced infection control panoramic radiograph |
| 00316C |
加強感染管制年度X光檢查 |
Enhanced infection control annual radiograph |
| 00317C |
加強感染管制高齲齒族群年度X光檢查 |
Enhanced infection control annual radiograph - high-risk |
| 00318C |
加強感染管制自閉症、失智症及重度以上身障診察費 |
Enhanced infection control fee - autism, dementia, extreme disability |
| 34001C |
根尖周圍X光攝影 |
Periapical radiography |
| 34002C |
咬翼X光攝影 |
Bite-wing radiography |
| 34003C |
咬合X光攝影 |
Occlusal radiography |
| 34004C |
全口X光攝影 |
Panoramic radiograph |
| 34005B |
頭顱側面X光攝影 |
Cephalometric radiography |
| 34006B |
顳顎關節X光攝影(單側) |
Temporomandibular joint radiography (unilateral) |
| 89001C |
銀粉充填-一面 |
Amalgam restoration - single surface |
| 89002C |
銀粉充填-二面 |
Amalgam restoration - two surfaces |
| 89003C |
銀粉充填-三面 |
Amalgam restoration - three surfaces |
| 89004C |
複合樹脂充填-前牙一面 |
Composite resin anterior restoration - single surface |
| 89005C |
複合樹脂充填-前牙二面 |
Composite resin anterior restoration - two surfaces |
| 89006C |
覆髓處置 |
Pulp capping |
| 89007C |
乳牙不鏽鋼牙冠(每顆) |
Pin reinforcement (per pin) |
| 89008C |
複合樹脂充填-後牙一面 |
Composite resin posterior restoration - single surface |
| 89009C |
複合樹脂充填-後牙二面 |
Composite resin posterior restoration - two surfaces |
| 89010C |
複合樹脂充填-後牙三面 |
Composite resin posterior restoration - three surfaces |
| 89011C |
玻璃乳色體充填 |
Glass ionomer cement restoration |
| 89012C |
複合樹脂充填-前牙三面 |
Three-surface composite resin anterior restoration |
| 89013C |
康乳體充填 |
Compomer restoration |
| 89014C |
複合樹脂充填-前牙雙鄰面 |
Composite resin anterior bilateral proximal restoration |
| 89015C |
複合樹脂充填-後牙雙鄰面 |
Composite resin posterior bilateral proximal restoration |
| 89088C |
牙體復形轉診費 |
Referral fee for dental restoration |
| 89101C |
銀粉充填-一面(特殊) |
Amalgam restoration - single surface (special) |
| 89102C |
銀粉充填-二面(特殊) |
Amalgam restoration - two surfaces (special) |
| 89103C |
銀粉充填-三面(特殊) |
Amalgam restoration - three surfaces (special) |
| 89104C |
複合樹脂前牙充填-一面(特殊) |
Composite anterior restoration - single surface (special) |
| 89105C |
複合樹脂前牙充填-二面(特殊) |
Composite anterior restoration - two surfaces (special) |
| 89106C |
複合樹脂後牙充填-一面(特殊) |
Composite posterior restoration - single surface (special) |
| 89107C |
複合樹脂後牙充填-二面(特殊) |
Composite posterior restoration - two surfaces (special) |
| 89108C |
特殊需求後牙複合樹脂-一面 |
Special needs posterior composite - single surface |
| 89109C |
特殊需求後牙複合樹脂-二面 |
Special needs posterior composite - two surfaces |
| 89110C |
特殊需求後牙複合樹脂-三面 |
Special needs posterior composite - three surfaces |
| 89111C |
特殊需求玻璃乳色體充填 |
Special needs glass ionomer restoration |
| 89112C |
特殊需求前牙三面複合樹脂 |
Special needs anterior three-surface composite |
| 89114C |
特殊需求前牙雙鄰面複合樹脂 |
Special needs anterior bilateral proximal composite |
| 89115C |
特殊需求後牙雙鄰面複合樹脂 |
Special needs posterior bilateral proximal composite |
| 90001C |
根管治療-單根管 |
Endodontic treatment - single root canal |
| 90002C |
根管治療-二根管 |
Endodontic treatment - two root canals |
| 90003C |
根管治療-三根管 |
Endodontic treatment - three root canals |
| 90019C |
根管治療-四根管 |
Endodontic treatment - four root canals |
| 90020C |
根管治療-五根管以上 |
Endodontic treatment - five or more root canals |
| 90004C |
根管急症處理 |
Endodontic emergency management |
| 90005C |
乳牙斷髓術 |
Pulpotomy of primary tooth |
| 90006C |
牙橋切除 |
Removal of bridged crown |
| 90007C |
全冠牙冠切除 |
Removal of full veneer crown |
| 90008C |
釘柱移除(每支) |
Removal of post (per post) |
| 90091C |
根管困難案例-C型根管 |
Endodontic difficult case - C-shaped root canal |
| 90092C |
根管困難案例-額外根管 |
Endodontic difficult case - additional root canals |
| 90093C |
根管困難案例-嚴重彎曲/鈣化/器械斷裂 |
Endodontic difficult case - severely curved/calcified canals |
| 90094C |
根管困難案例-再治療有阻塞 |
Endodontic difficult case - retreatment with obstruction |
| 90095C |
多根管根管治療-二根管 |
Multi-root canal endodontic treatment - two canals |
| 90096C |
多根管根管治療-三根管 |
Multi-root canal endodontic treatment - three canals |
| 90097C |
多根管根管治療-四根管 |
Multi-root canal endodontic treatment - four canals |
| 90098C |
多根管根管治療-五根管以上 |
Multi-root canal endodontic treatment - five+ canals |
| 90010C |
根尖充填 |
Root-end filling |
| 90011C |
意向性牙齒再植術 |
Intentional tooth replantation |
| 90012C |
橡皮障防濕裝置 |
Rubber dam isolation |
| 90013C |
根尖成形術-前牙 |
Apexification or apexogenesis - anterior tooth |
| 90014C |
根尖成形術-後牙 |
Apexification or apexogenesis - posterior tooth |
| 90015C |
根管開擴及清創 |
Access cavity preparation, canal cleaning and shaping |
| 90016C |
乳牙根管治療 |
Endodontic treatment of primary tooth |
| 90017C |
恆牙斷髓術 |
Pulpotomy of permanent tooth |
| 90018C |
乳牙多根管根管治療 |
Endodontic treatment of primary tooth with multiple canals |
| 90021C |
束縛帶保護性約束 |
Protective physical restraint for special needs patients |
| 90088C |
根管治療轉診費 |
Referral fee for endodontic treatment |
| 90112C |
特殊需求橡皮障 |
Rubber dam isolation for special needs patients |
| P7303C |
超音波根管沖洗 |
Ultrasonic irrigation in endodontics |
| 91001C |
牙周急症處理 |
Management of periodontal emergencies |
| 91002C |
牙周敷料 |
Periodontal packing |
| 91003C |
局部洗牙 |
Scaling - localized |
| 91004C |
全口洗牙 |
Scaling - full mouth |
| 91006C |
齦下刮除術(含牙根整平術)-全口 |
Subgingival curettage (including root planing) - full mouth |
| 91007C |
齦下刮除術(含牙根整平術)-半顎 |
Subgingival curettage (including root planing) - half arch |
| 91008C |
齦下刮除術(含牙根整平術)-局部 |
Subgingival curettage (including root planing) - localized |
| 91009B |
牙周翻瓣手術-局部(≤3齒) |
Periodontal flap operation - localized |
| 91010B |
牙周翻瓣手術-1/3顎(4-6齒) |
Periodontal flap operation - 1/3 arch |
| 91011C |
牙齦切除術-局部(≤3齒) |
Gingivectomy - localized |
| 91012C |
牙齦切除術-1/3顎 |
Gingivectomy - 1/3 arch |
| 91013C |
牙齦切除術-根管或復形用途 |
Gingivectomy for endodontic or restorative purposes |
| 91088C |
牙周病轉診費 |
Referral fee for periodontal treatments |
| 91014C |
牙菌斑控制 |
Plaque control |
| 91103C |
特殊需求局部洗牙 |
Scaling for special needs patients - localized |
| 91104C |
特殊需求全口洗牙 |
Scaling for special needs patients - full mouth |
| 91114C |
特殊需求牙菌斑控制 |
Plaque control for special needs patients |
| 91005C |
口乾症全口洗牙 |
Full mouth scaling for xerostomia patients |
| 91015C |
牙周統合治療-9≤齒數≤15 |
Comprehensive periodontal treatment - 9 to 15 teeth |
| 91016C |
牙周統合治療-4≤齒數≤8 |
Comprehensive periodontal treatment - 4 to 8 teeth |
| 91091C |
牙周統合治療-1≤齒數≤3 |
Comprehensive periodontal treatment - 1 to 3 teeth |
| 91017C |
孕婦全口洗牙 |
Full mouth scaling for pregnant women |
| 91018C |
牙周支持性治療 |
Supportive periodontal treatment |
| 91019C |
孕婦牙周急症處理 |
Management of periodontal disease emergencies for pregnant women |
| 91020C |
兒童牙菌斑去除照護 |
Dental plaque removal care |
| 91089C |
糖尿病全口洗牙 |
Full mouth scaling for patients with diabetes mellitus |
| 91021C |
牙周統合治療-第一階段 |
Comprehensive periodontal treatment - stage 1 |
| 91022C |
牙周統合治療-第二階段 |
Comprehensive periodontal treatment - stage 2 |
| 91023C |
牙周統合治療-第三階段 |
Comprehensive periodontal treatment - stage 3 |
| 92001C |
不特定局部治療 |
Unspecified local treatment |
| 92066C |
指定局部治療 |
Specified local treatment |
| 92002C |
暫時性牙齒固定(一顆) |
Temporary splinting for one tooth |
| 92003C |
口內切開引流(含引流管) |
Intraoral incision and drainage with drains |
| 92004C |
口外切開引流 |
Extraoral incision and drainage |
| 92005C |
拆線 |
Removal of stitches |
| 92006C |
拆除固定鋼絲 |
Removal of splinting wire |
| 92007B |
骨折閉鎖性復位併齒間固定(≤3齒) |
Closed reduction with interdental wiring fixation - 3 teeth or fewer |
| 92008B |
骨折閉鎖性復位併齒間固定(≥4齒) |
Closed reduction with wiring fixation - 4 teeth or more |
| 92009C |
拆除副木 |
Removal of splint |
| 92010B |
上下顎間固定術 |
Intermaxillary fixation |
| 92011B |
環狀結紮 |
Circumferential wiring |
| 92012C |
拔牙傷口術後處理 |
Post-operative care of extraction wound |
| 92013C |
簡單拔牙 |
Simple extraction |
| 92014C |
複雜拔牙 |
Complex extraction |
| 92017C |
囊腫摘除-小(<2cm) |
Cystic enucleation - small |
| 92018B |
囊腫摘除-中(2-4cm) |
Cystic enucleation - medium |
| 92019B |
囊腫摘除-大(>4cm) |
Cystic enucleation - large |
| 92021B |
軟組織切片 |
Biopsy, soft tissue |
| 92022B |
硬組織切片 |
Biopsy, hard tissue |
| 92023B |
造袋術 |
Marsupialization |
| 92024B |
瘻管切除術 |
Fistulectomy |
| 92026B |
骨腐骨去除術-簡單(≤1/3顎) |
Sequestrectomy - simple |
| 92025B |
骨腐骨去除術-複雜(>1/3顎) |
Sequestrectomy - complex |
| 92027C |
齦瓣切除術 |
Operculectomy |
| 92028C |
繫帶切除術-簡單 |
Frenectomy - simple |
| 92029C |
繫帶切除術-Z型整形 |
Frenectomy - Z-plasty |
| 92030C |
根尖切除術-門牙及犬齒 |
Apicoectomy - incisors and canines |
| 92031C |
根尖切除術-小臼齒 |
Apicoectomy - premolars |
| 92032C |
根尖切除術-大臼齒 |
Apicoectomy - molars |
| 92033C |
半切除術或牙根截切術 |
Hemisection or root amputation |
| 92035B |
神經切除術 |
Neurectomy |
| 92036B |
口腔缺損皮膚或黏膜移植 |
Skin or mucosal grafts for intraoral defects |
| 92037B |
導管內唾液腺結石摘除 |
Sialolithotomy, within duct |
| 92038B |
皮瓣修復-小(<4cm2) |
Flap repair - small |
| 92039B |
皮瓣修復-中(4-16cm2) |
Flap repair - medium |
| 92040B |
皮瓣修復-大(>16cm2) |
Flap repair - large |
| 92041C |
齒槽骨整形術(<1/2顎) |
Alveoloplasty - less than half arch |
| 92042C |
齒槽骨整形術(>1/2顎) |
Alveoloplasty - more than half arch |
| 92043C |
顳顎關節脫臼閉鎖性復位-不固定 |
Closed reduction of TMJ dislocation - without fixation |
| 92044B |
顳顎關節脫臼閉鎖性復位-固定 |
Closed reduction of TMJ dislocation - with fixation |
| 92045B |
自體牙齒移植術 |
Tooth autotransplantation |
| 92046A |
酒精注射術 |
Alcohol injection |
| 92047B |
顳顎關節內注射 |
Intra-articular injection of temporomandibular joint |
| 92048A |
唾液腺導管探通術 |
Salivary gland catheterization |
| 92049B |
黏膜下注射 |
Submucosal injection |
| 92050C |
手術暴露埋伏齒 |
Surgical exposure of impacted tooth |
| 92051B |
全口塗氟 |
Full mouth topical fluoride application |
| 92052B |
贗復體/手術副木治療 |
Obturator / surgical splint therapy |
| 92053B |
咬合板治療 |
Occlusal bite splint therapy |
| 92054B |
軟式咬合板治療 |
Soft splint therapy |
| 92055C |
乳牙拔牙 |
Primary tooth extraction |
| 92060B |
手術鉤用於上下顎間固定 |
Surgical hooks for IMF |
| 92061B |
空間維持器(每顎) |
Space retainer treatment per jaw |
| 92062C |
唾液腺導管沖洗 |
Salivary duct irrigation |
| 92067B |
癌前病變軟組織切片 |
Incisional biopsy for precancerous lesion, soft tissue |
| 92068B |
癌前病變硬組織切片 |
Incisional biopsy for precancerous lesion, hard tissue |
| 92065B |
口腔顎面頸部惡性腫瘤術後照護 |
Post-operative care for oral-maxillofacial and neck malignancies |
| 92088C |
口腔外科轉診費 |
Referral fee for oral maxillofacial surgery |
| 92069B |
複雜顳顎關節障礙咬合板治療 |
Occlusal bite splint for complicated TMD |
| 92070B |
複雜顳顎關節障礙咬合板追蹤調整 |
Follow-up and adjustment of complicated TMD splint |
| 92071C |
簡單口內切開引流 |
Simple intraoral incision and drainage |
| 92072C |
口乾症全口塗氟 |
Full mouth topical fluoride for xerostomia patients |
| 92073C |
困難口腔黏膜疾病處置 |
Management of difficult oral mucosal disease |
| 92089B |
氟膠托(每顎) |
Fluoride tray per jaw |
| 92090C |
口腔癌或癌前病變定期照護 |
Periodic care for oral cancer or oral potentially malignant disorder |
| 92091C |
口腔癌或癌前病變不定期照護 |
Occasional care for oral cancer or PMD |
| 92092C |
複雜乳牙拔牙 |
Complex extraction of primary tooth |
| 92093B |
牙科急診處置 |
Management of dental emergencies |
| 92094C |
牙科急診處置-假日 |
Dental emergency management Saturdays/Sundays/holidays |
| 92095C |
顎骨壞死傷口照護 |
Wound care for osteonecrosis of jaws |
| 92096C |
牙外傷急症處置 |
Management of dental trauma emergencies |
| 92097C |
顳顎關節障礙特殊評估-初診 |
Special evaluation for TMD - first visit |
| 92098C |
顳顎關節障礙特殊評估-複診 |
Special evaluation for TMD - return visit |
| 92099B |
顱下顎障礙乾針治療 |
Dry needling for craniomandibular disorders |
| 92100B |
顳顎關節沖洗術 |
Arthrocentesis of temporomandibular joint |
| 92129B |
顎面外傷術後初次記錄/照護 |
Primary post-operative recording/care for maxillofacial trauma |
| 92130B |
顎面外傷術後照護 |
Post-operative care for maxillofacial trauma |
| 92015C |
簡單阻生齒拔除 |
Simple odontectomy |
| 92016C |
複雜阻生齒拔除 |
Complex odontectomy |
| 92020B |
口腔軟組織腫瘤切除 |
Excision of soft tissue tumor in oral cavity |
| 92034B |
口腔上頷竇瘻管修補 |
Repair oro-antral fistula or communication |
| 92056C |
骨腫瘤切除(<1cm) |
Excision of bone tumor - less than 1cm |
| 92057C |
骨腫瘤切除(1-2cm) |
Excision of bone tumor - 1 to 2cm |
| 92058C |
骨腫瘤切除(>2cm) |
Excision of bone tumor - more than 2cm |
| 92059C |
上頷竇內牙齒/異物手術摘除 |
Surgical removal of tooth/foreign body in maxillary sinus |
| 92063C |
深度埋伏齒手術摘除 |
Surgical removal of deeply impacted tooth |
| 92064C |
組織間隙內牙齒/異物手術摘除 |
Surgical removal of tooth/foreign body in fascial spaces |
| 92161B |
唾液腺切片(每處) |
Salivary gland biopsy per site |
| 92201B |
髁突下骨切開術/關節成形術(單側) |
Subcondylar osteotomy or arthroplasty, unilateral |
| 92202B |
腺內唾液腺結石摘除 |
Sialolithotomy, in the gland |
| 92203B |
髁突切除術(單側) |
Condylectomy unilateral |
| 92204B |
碟化術及骨腐骨去除術 |
Saucerization and sequestrectomy |
| 92205B |
碟化術 |
Saucerization |
| 92206B |
髁突骨折開放性復位(單側) |
Open reduction of condylar fracture, unilateral |
| 92207B |
顎成形術 |
Palatoplasty |
| 92208B |
顴骨弓復位術 |
Reduction of zygomatic arch |
| 92209B |
頷骨骨折開放性復位-簡單 |
Open reduction of jaw fracture - simple |
| 92210B |
頷骨骨折開放性復位-複雜 |
Open reduction of jaw fracture - complicated |
| 92211B |
頷骨切除術-邊緣 |
Resection of jaw - marginal |
| 92212B |
頷骨切除術-部分 |
Resection of jaw - partial |
| 92213B |
頷骨切除術-半邊 |
Resection of jaw - hemi-resection |
| 92214B |
頷骨重建-骨移植 |
Reconstruction of jaw by bone grafting |
| 92215B |
頷骨重建-骨板 |
Reconstruction of jaw by bridging plate |
| 92218B |
唾液腺切除術-淺層或良性 |
Sialoadenectomy - superficial or benign |
| 92219B |
唾液腺切除術-惡性 |
Sialoadenectomy - malignant |
| 92220B |
周邊神經切除術 |
Peripheral neurectomy |
| 92221B |
周邊神經切除術-下齒槽神經 |
Peripheral neurectomy - inferior alveolar nerve |
| 92222B |
顳顎關節脫臼開放性復位 |
Open reduction for TMJ dislocation |
| 92223A |
雙顎手術或Le Fort III骨切開術 |
Two jaw surgery or Le Fort III osteotomy |
| 92224A |
單顎或雙處手術 |
One jaw or two sites surgery |
| 92225A |
單處手術 |
Single site jaw surgery |
| 92229B |
快速上顎擴張器治療 |
Rapid palatal expander treatment |
| 92230B |
顳顎關節鏡手術 |
Temporomandibular joint arthroscopy |
| 96001C |
牙科局部麻醉 |
Dental localized anesthesia |