What D3220 means

D3220 covers a therapeutic pulpotomy (excluding the final restoration). "D" is dental, "32" is the pulpotomy/pulpectomy endodontic group, and "20" is this therapeutic pulpotomy. The pulp has a coronal part (in the crown/chamber of the tooth) and a radicular part (in the roots/canals). A pulpotomy removes the coronal pulp (the pulp in the chamber, coronal to the dentinocemental junction) while preserving the vital radicular pulp (the pulp in the roots), then places a medicament over the remaining radicular pulp. This treats a tooth where the coronal pulp is affected (e.g., by decay) but the radicular pulp is still vital and healthy — removing the affected coronal portion while keeping the root pulp alive, so the tooth (commonly a baby tooth) can be retained. The code excludes the final restoration (coded separately).

So it's removing the coronal pulp and medicating the remaining vital root pulp, to treat a tooth (often a baby tooth) while keeping its root pulp vital.

A therapeutic pulpotomy is most commonly done on primary (baby) teeth — when a baby tooth has deep decay reaching the coronal pulp, a pulpotomy removes the affected coronal pulp and preserves the radicular pulp (with a medicament like MTA, ferric sulfate, or formocresol), so the baby tooth can be retained until it naturally falls out (rather than extracting it). It can sometimes be done on young permanent teeth too. It's distinct from a full root canal (which removes all the pulp) and from pulpal debridement (D3221). The code includes the access and coronal pulp removal and the interim restoration, but not the final restoration (e.g., a stainless steel crown, coded separately). It's intended for vital pulp cases (preserving the radicular pulp); it's not used when it's a precursor step to a root canal. Coverage is under endodontic benefits; documentation supports the claim.

When it's typically used

D3220 is reported for a therapeutic pulpotomy — removing the coronal pulp while preserving the vital radicular pulp and placing a medicament, commonly on a baby tooth (or sometimes a young permanent tooth) where the coronal pulp is affected but the root pulp is still vital, to treat the tooth and retain it (until natural exfoliation, for a baby tooth).

How much does D3220 cost?

A therapeutic pulpotomy is a moderate fee, often roughly 150 to 350 USD depending on region — for removing the coronal pulp and medicating the radicular pulp (the final restoration, like a stainless steel crown, being separate). It's commonly done on baby teeth to retain them, less than a full root canal.

Is D3220 covered by insurance?

Covered under endodontic benefits, commonly for baby teeth (a standard treatment for preserving them). Some plans may not reimburse until the final restoration is placed. Documentation of the vital pulp condition and the pulpotomy supports the claim. The final restoration (e.g., a stainless steel crown, D2930) is coded separately. It's distinct from pulpal debridement (D3221) and full root canal. Verifying coverage helps.

What a pulpotomy does

A pulpotomy treats the pulp in a specific way, and understanding it clarifies this procedure.

The pulp has two parts: the coronal pulp (in the crown/chamber of the tooth) and the radicular pulp (in the roots/canals). A therapeutic pulpotomy treats a tooth by removing the coronal pulp (the part in the chamber) while preserving the radicular pulp (the part in the roots). The process: the dentist accesses the pulp chamber, removes the coronal pulp (which may be affected/inflamed from decay reaching it), and — keeping the still-vital radicular pulp in the roots — places a medicament over the remaining radicular pulp (to treat it, help it stay healthy, and seal it). So a pulpotomy removes the affected coronal portion of the pulp while keeping the root portion vital.

This is useful when a tooth's coronal pulp is affected (e.g., decay has reached and inflamed the coronal pulp) but the radicular pulp is still vital and healthy. Rather than removing all the pulp (a full root canal/pulpectomy) or losing the tooth, the pulpotomy removes just the affected coronal pulp and preserves the healthy root pulp — allowing the tooth to be retained with its root pulp still vital. This is especially valuable for baby teeth (preserving them until they naturally fall out). The medicament over the radicular pulp helps it remain healthy. So the pulpotomy is a partial pulp treatment — removing the coronal pulp, preserving the radicular pulp. For patients (parents, for baby teeth), understanding what a pulpotomy does — removing the affected coronal pulp while preserving the vital radicular pulp and medicating it — clarifies this procedure. It treats the affected coronal pulp while keeping the root pulp vital. The dentist performs a pulpotomy when the coronal pulp is affected but the root pulp is healthy. Understanding this helps patients see that a pulpotomy removes the affected coronal pulp and preserves the healthy radicular pulp (with a medicament) — treating the tooth while keeping its root pulp vital — so the tooth (commonly a baby tooth) can be retained, a partial pulp treatment for when the coronal pulp is affected but the root pulp is still healthy.

Pulpotomies on baby teeth

Pulpotomies are most commonly done on baby teeth, and understanding why clarifies this main application.

The therapeutic pulpotomy is most commonly performed on primary (baby) teeth. When a baby tooth has deep decay that reaches the coronal pulp (inflaming or affecting it) but the radicular pulp is still vital, a pulpotomy is a standard treatment: removing the affected coronal pulp and preserving the radicular pulp (with a medicament), so the baby tooth can be retained. This is valuable because retaining the baby tooth (rather than extracting it) is beneficial — baby teeth hold space for the permanent teeth, aid chewing and speech, and serve until they naturally fall out, so preserving a salvageable baby tooth helps maintain these functions and the space (premature loss can lead to space/alignment issues for the permanent teeth). So a pulpotomy lets a decayed baby tooth (with affected coronal pulp but healthy root pulp) be saved and retained until natural exfoliation.

After a baby-tooth pulpotomy, the tooth is typically restored with a crown (often a stainless steel crown, D2930) for full-coverage protection (the tooth, having had the pulpotomy and significant decay, benefiting from the crown's durability). So the pulpotomy plus a crown restores and protects the baby tooth. The pulpotomy is a common, well-established pediatric procedure for managing baby teeth with deep decay reaching the coronal pulp. The medicaments used (MTA, ferric sulfate, formocresol, depending on the practice) treat the radicular pulp. The dentist performs a pulpotomy on a suitable baby tooth (affected coronal pulp, vital radicular pulp). For patients (parents), understanding that pulpotomies are most commonly done on baby teeth — to treat deep decay reaching the coronal pulp while preserving the root pulp, so the baby tooth can be retained — clarifies this main application. It saves salvageable baby teeth. The dentist performs it on suitable baby teeth, usually with a crown afterward. Understanding this helps parents see that a pulpotomy is a common treatment for a baby tooth with deep decay reaching the pulp — removing the affected coronal pulp, preserving the healthy root pulp, and (with a crown) retaining the tooth until it naturally falls out — preserving the baby tooth's function and space-holding role rather than extracting it.

Pulpotomy vs root canal vs pulpal debridement

A pulpotomy differs from related pulp procedures, and understanding the distinctions clarifies which applies.

Several pulp procedures differ in how much pulp is removed and the intent. A therapeutic pulpotomy (D3220) removes the coronal pulp while preserving the vital radicular pulp (the root pulp stays alive) — the tooth remains vital (in its roots), commonly for baby teeth. A full root canal (pulpectomy/root canal therapy) removes all the pulp (coronal and radicular) — the tooth becomes non-vital (no living pulp), used when the whole pulp is irreversibly affected or necrotic (for permanent teeth, this is endodontic therapy D3310/D3320/D3330; for primary teeth, pulpal therapy with a resorbable filling, D3230/D3240). Pulpal debridement (D3221) is the removal of pulp for the relief of acute pain (an emergency procedure, often an initial step) — distinct from the therapeutic pulpotomy's intent of preserving the radicular pulp. So the procedures differ: pulpotomy (remove coronal, preserve radicular, tooth stays vital), full root canal (remove all pulp, tooth non-vital), and pulpal debridement (remove pulp for acute pain relief).

The choice depends on the pulp's condition and the intent. A pulpotomy is for when the coronal pulp is affected but the radicular pulp is still vital and healthy (preserving the root pulp) — commonly baby teeth. A full root canal is for when the whole pulp is irreversibly affected/non-vital (removing it all). Pulpal debridement is for acute pain relief (an emergency step). The dentist determines which is appropriate based on the pulp's condition. For patients, understanding that a pulpotomy (remove coronal pulp, preserve radicular), a full root canal (remove all pulp), and pulpal debridement (remove pulp for acute pain) differ clarifies which applies. The pulpotomy preserves the root pulp (tooth stays vital); the root canal removes all pulp; debridement is for acute pain. The dentist determines the appropriate procedure. Understanding the distinctions helps patients see why a pulpotomy (preserving the radicular pulp, commonly for a baby tooth) might be done versus a full root canal (removing all the pulp) or pulpal debridement (for acute pain relief) — based on the pulp's condition and the intent — with the pulpotomy being the procedure that preserves the vital root pulp while removing the affected coronal pulp.

After the pulpotomy

A pulpotomy is followed by restoring the tooth, and understanding what follows clarifies the overall treatment.

A therapeutic pulpotomy treats the pulp, and the tooth then needs to be restored (the code excludes the final restoration). After the pulpotomy (removing the coronal pulp, medicating the radicular pulp), the tooth is restored to protect it and restore its function. For a baby tooth (the most common case), this is typically a stainless steel crown (D2930) — providing durable, full-coverage protection for the tooth (which has had the pulpotomy and significant decay), so it can function until it naturally falls out. So the typical sequence for a baby tooth is: pulpotomy (treat the pulp), then a stainless steel crown (restore and protect the tooth). The crown is coded separately from the pulpotomy.

So the pulpotomy is part of a treatment that includes restoring the tooth — the pulpotomy addressing the pulp, the crown (or other restoration) protecting and restoring the tooth. The combination retains the tooth (commonly a baby tooth) in function until natural exfoliation. After treatment, the tooth is monitored (at regular dental visits) to confirm it stays healthy (the pulpotomy succeeding, the radicular pulp staying healthy) and the crown serving well. If problems arise (rare), further treatment might be needed, but pulpotomies on baby teeth are generally successful. The dentist performs the pulpotomy and the restoration as part of treating the tooth. For patients (parents), understanding that a pulpotomy is followed by restoring the tooth (typically a stainless steel crown for a baby tooth) clarifies the overall treatment. The pulpotomy treats the pulp; the crown protects the tooth. The dentist does both as part of retaining the tooth. Understanding what follows helps patients see that a pulpotomy is part of a treatment that includes restoring the tooth — typically a stainless steel crown for a baby tooth — so the tooth is treated (the pulp) and protected (the crown), retaining it in function until it naturally falls out, with the pulpotomy and the restoration together preserving the salvageable tooth.

Frequently asked questions

What is the D3220 dental code?

It's a therapeutic pulpotomy — removing the coronal (crown-portion) pulp while preserving the vital radicular (root-portion) pulp, then placing a medicament, commonly on baby teeth. It treats a tooth with affected coronal pulp while keeping the root pulp vital, so the tooth can be retained.

What does a pulpotomy do?

It removes the affected coronal pulp (in the tooth's chamber) while preserving the still-vital radicular pulp (in the roots), placing a medicament over the remaining root pulp. So it treats the affected coronal portion while keeping the root pulp alive, allowing the tooth to be retained.

Why are pulpotomies common on baby teeth?

When a baby tooth has deep decay reaching the coronal pulp but the root pulp is still vital, a pulpotomy saves the tooth (rather than extracting it). Retaining the baby tooth preserves its functions and holds space for the permanent tooth until it naturally falls out.

How is it different from a root canal?

A pulpotomy removes only the coronal pulp, preserving the vital radicular (root) pulp — the tooth stays vital in its roots. A full root canal removes all the pulp (the tooth becomes non-vital), used when the whole pulp is irreversibly affected. Pulpal debridement (D3221) is for acute pain relief.

How much does a pulpotomy cost?

Often around 150 to 350 USD for removing the coronal pulp and medicating the radicular pulp (the final restoration, like a stainless steel crown, being separate). It's commonly done on baby teeth to retain them, less than a full root canal.

What happens after a pulpotomy?

The tooth is restored — typically a stainless steel crown (D2930) for a baby tooth, providing durable full-coverage protection so the tooth functions until it naturally falls out. So the pulpotomy (treating the pulp) plus a crown (protecting the tooth) retains the tooth. The crown is coded separately.

This page is an independent, plain-language explanation for general information only. It is not billing, coding, or clinical advice. For the official CDT descriptor and current-year wording, refer to the American Dental Association.