Costs, price factors and 2026 schemes
Bone grafts, sinus lifts and CBCT scans: the extra costs on an implant quote
Why implant quotes add bone grafts, sinus augmentation, CBCT scans, surgical guides and sedation, the ADA items for each, and how they change the total and your fund benefit.
Many implant quotes include more than the implant and crown. The most common additions are a cone beam CT (CBCT) scan for 3D planning (ADA item 026, with analysis items 087–091), a bone graft where the jawbone is too thin or has a defect (243 particulate or 244 block), a maxillary sinus augmentation ("sinus lift") for upper back teeth (246 trans-alveolar or 247 lateral wall), soft tissue grafts (235), a surgical guide (679), and sometimes intravenous sedation (942). Each is a separate procedure with its own fee and, on extras, its own benefit rules. Together they can add a large share to the implant total and extend the timeline by months. This guide explains what each line is, why it may appear on a quote, and how to price it. It is part of the implant cost overview.
The common extra items
| Item | ADA description | Why it may be quoted | Cost effect |
|---|---|---|---|
| 026 | Cone Beam Computed Tomography: scan acquisition, per appointment | 3D view of bone and nearby structures for planning | One-off; sometimes done by an external radiology provider who bills separately |
| 087–091 | CBCT analysis and/or interpretation (by field of view) | Reporting on the scan | Sometimes included with 026, sometimes separate |
| 678 | Diagnostic template | Radiographic template for planning | One-off |
| 679 | Surgical implant guide | Appliance showing ideal location and angle for placement | One-off per guide |
| 243 | Osseous graft, per tooth or implant | Particulate bone or substitute to repair or augment bone around an implant site | Per site; materials add cost |
| 244 | Osseous graft, block | Block of bone secured with screws to augment a ridge | Usually a separate surgery and healing period |
| 246 | Maxillary sinus augmentation, trans-alveolar technique, per sinus | Raising the sinus floor through the implant site | Often at the same visit as the implant |
| 247 | Maxillary sinus augmentation, lateral wall approach, per sinus | Larger augmentation through the side wall, with grafting | Often a separate surgery and longer healing |
| 235 | Gingival graft, per tooth, implant or extraction socket | Soft tissue grafting | Per site |
| 236 | Guided tissue regeneration, per tooth or implant | Membrane-guided healing | Per site |
| 942 | Sedation, intravenous, per 30 minutes or part thereof | Comfort or anxiety management | Time-based; may involve a sedationist |
An illustrative quote with additions
All fees are illustrative and for arithmetic only.
| Line | Item | Illustrative fee |
|---|---|---|
| CBCT scan and report | 026 + 088 | $400 |
| Surgical guide | 679 | $450 |
| Extraction of the failed tooth | 322 | $450 |
| Implant, two-stage | 684 | $2,700 |
| Sinus augmentation, lateral wall | 247 | $2,200 |
| Second-stage surgery | 691 | $450 |
| Abutment | 661 | $900 |
| Implant crown, non-metallic | 671 | $1,900 |
| IV sedation, 60 minutes | 942 × 2 | $900 |
| Total | $10,350 |
Without the sinus augmentation, sedation and guide, the same tooth would be $10,350 − $2,200 − $900 − $450 = $6,800. So in this example the additions account for about a third of the bill ($3,550 ÷ $10,350 ≈ 34%).
How additions affect your fund benefit
- Different categories. A fund may treat 026 as general dental, 247 as periodontic or oral surgery, 942 as general or not cover it, and implant items as major dental or excluded. The same quote can draw on several limits.
- Limits run out. With a single major dental limit of, say, $1,500, larger quotes do not earn proportionally more.
- Some items may not be covered at all. Ask item by item. Do not assume "implants covered" includes the graft or sinus work.
- Hospital admission. If the surgery is done in hospital, hospital cover with the dental surgery category may pay hospital charges, but the dental items are still billed separately.
Use the extras benefit calculator for each category separately.
Timing and staged fees
Grafting can change both the timeline and the payment schedule:
- Same-visit graft or trans-alveolar sinus augmentation (246): done with the implant; one surgical fee date.
- Separate graft or lateral-wall sinus augmentation (247/244): a first surgery, months of healing, then the implant. Payment may be split, and stages may fall in different fund limit periods. See timing treatment around extras limits.
- "If required" lines: some quotes list a graft as possible. Ask for both totals (with and without) in writing, and whether you will be asked before it is done.
Questions to ask about each addition
- Which items are definite and which are "if required"?
- Is the CBCT scan billed by the practice or a separate radiology provider, and is the report included?
- If a graft is needed, is it done at the same time as the implant or separately?
- What material will be used, and does the fee include it?
- What are the sedation fees, and who provides the sedation?
- How do the additions change the time to the final crown?
Frequently asked questions
Can I skip the CBCT scan to save money?
That is a clinical question about safe planning. From a cost viewpoint, ask whether a scan you already have (for example from a specialist) can be reused, and whether the analysis is included.
Is a sinus lift always needed for upper back teeth?
No; it depends on the bone available, which imaging shows. Ask to see the reason on your plan.
Why is IV sedation charged in 30-minute blocks?
Item 942 is defined per 30 minutes or part thereof, so a 61-minute procedure counts as three units.
Do public dental services do grafts and sinus lifts?
Rarely, because public services rarely provide implants. See public dental by state.
Sources
- Australian Dental Association — item descriptions for 026, 087–091, 243, 244, 246, 247, 679 and 942
- privatehealth.gov.au — how extras and hospital cover treat dental services
- Ahpra — check the registration of the dentist, specialist and any sedationist
