D1110 Dental Code: Adult teeth cleaning (prophylaxis) Cost in 2026

What D1110 means on your bill

D1110 is the code for a standard adult cleaning, also called a prophylaxis: removing plaque and surface tartar from a patient whose gums show no sign of disease. It is billed with an exam (D0120) and often bitewing X-rays, assuming the hygienist works above the gumline on healthy tissue. Once tartar sits below the gumline, or the gums start pulling away from the teeth, the appointment is coded as scaling instead, D4346 or D4341/D4342 for a more advanced case, billed and covered on different terms. Choosing between a routine cleaning and a scaling code is clinical, not a preference, and it changes the fee, the coverage tier, and how often insurance pays again. Related guide: teeth cleaning and exam cost.

D1110 cost: cash fair price vs what Medicaid paid (2026)

D1110 prices well below the scaling codes it can turn into once gum disease is present, and the chart reflects that preventive tier: the cash fair price runs $50–$350, typical $203. Medicaid paid dentists a national average of $45 per claim line across 21,051,464 claim lines in 2023-2024, a gap of 4.5x against the cash figure. That paid amount is the program's weighted-average payment to the dentist, drawn from HHS T-MSIS, not a bill the patient sees. Only about 20% of active dentists billed Medicaid at all in 2023-2024, so getting a routine cleaning under Medicaid depends on finding a participating office as much as on this fee.

What Medicaid paid dentists for D1110, by state (2023-2024)

46 states publish a figure for D1110 below; the rest fail the data-quality gate or report too few claim lines. Payment ranges from $31 in New Jersey to $98 in Alaska for the same routine cleaning code. The cash column beside each state is that state's independent average outside insurance, shown for comparison, not derived from the Medicaid figure. A well-paid cleaning code in a given state does not mean that state's Medicaid program covers adult dental care broadly, or that it pays as well for the scaling codes a cleaning can become; see Medicaid adult dental by state for coverage rules. These figures track the cleaning alone. For an adult cleaning the official schedule rates spread more than the paid figures do: Ohio's $65 against New Jersey's $19 for the same D1110, and the Fee ÷ paid column is the plainest measure of how far below its own schedule a program actually pays per claim line.

Medicaid paid: per claim line, weighted average 2023-2024, derived from HHS T-MSIS Medicaid provider spending (Real Dental Costs, DOI 10.7910/DVN/7F2BZI); states with a data-quality flag or too few lines are omitted. Official Medicaid fee: the fee-for-service rate for this code on the state's published Medicaid dental fee schedule (captured for Illinois, Michigan, North Carolina, New Jersey, New York, Ohio, Pennsylvania, Texas, Wyoming; effective dates, source URLs and file hashes in the API file); "—" where no schedule was captured or the code is not on it. Michigan publishes $62 on its schedule but has no publishable paid row here (its Medicaid claims cannot be geolocated). Fee and paid differ by design: paid mixes managed-care encounters, reduced and bundled lines and 2023-2024 rates, while the schedule is the current fee-for-service rate. Schedule notes: Illinois: first two fee columns captured (fee_usd = first column); New Jersey: fee_usd = specialist adult column; fee_alt_usd = non-specialist adult column (child columns not captured); Ohio: first two fee columns captured (fee_usd = first column); Texas: no single effective date printed on the schedule; fee = most frequent non-zero rate across provider types; Wyoming: XLSX master schedule substituted for the ADA-indexed PDF (which carries no dental codes); effective date = latest active rate begin date. Cash: Real Dental Costs procedure API, adult teeth cleaning (prophylaxis) proxy = Exam, cleaning & X-rays (basis estimated). Program payments, not patient bills; not a quote.

How insurance classes D1110

Plans almost always class D1110 as preventive, reimbursed at 100% with no deductible, up to a frequency limit that is typically twice a year. A pre-treatment estimate is rarely needed for a routine cleaning itself, but becomes relevant the moment the hygienist finds tartar below the gumline and the visit is recoded as scaling, which usually falls into a different coverage tier with its own frequency rule. The annual maximum, commonly $1,000-$2,000 for the year, is built around the assumption that preventive visits cost little against it. If a cleaning is billed as scaling instead, ask what the exam found. Coverage explained: dental insurance guide.

Chains, schools and where D1110 costs less

Aspen Dental publishes $150 on average for a routine cleaning ($100-$250), close to the low end of the independent band of $50–$350 shown above. Dental school clinics, staffed by supervised students, typically charge 30-60% below private-practice fees for the same cleaning; see dental school cost. Every other procedure price on this site is listed at every procedure price. Cash averages for a routine cleaning range from $170 in Alabama to $260 in California.

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