D5225 — Maxillary partial denture — flexible base
A partial denture replaces some of the teeth in an arch and is held in place by the teeth that remain. D5225 is the version in a flexible nylon-type base, for the upper jaw.
It is one of 13 codes covering partial denture. For the procedure itself rather than the code, see the partial denture guide; for the code, read on.
Everything on this page is about the code itself — its conditions, its fee, its benefit handling, and the precise point at which it stops applying and a neighbouring code starts.
What has to be true for D5225 to apply
Material — a flexible nylon-type base. Flexible partial dentures are injection-moulded from a nylon-family polymer. The base is thin, slightly translucent so it disappears against the gum, and it flexes into place, which means the clasps can be made in the same pink material rather than in visible metal. The flexibility is also the limitation: it transmits chewing load to the gum rather than spreading it through a rigid frame, it cannot be relined or adjusted as easily as acrylic, and it cannot be repaired by most laboratories. The material is part of the code rather than a choice made afterwards, so D5225 is only the right code if that is what was actually used.
Arch — upper. The palate provides broad support for anything removable, but the sinuses sit directly above the back teeth, which constrains surgical work.
Told apart from the codes it is confused with
D5224 — Immediate mandibular partial denture — cast metal framework: It specifies a cast metal framework rather than a flexible nylon-type base.
D5226 — Mandibular partial denture — flexible base: It is the lower-jaw version.
D5223 — Immediate maxillary partial denture — cast metal framework: It specifies a cast metal framework rather than a flexible nylon-type base.
D5227 — Immediate maxillary partial denture — flexible base: It is the interim version.
D5225 sits in a group of 13 codes in total; the remainder are linked at the foot of this page. A single word separates several of these codes, and a payer reads that word literally. If the record does not support D5225 specifically, the claim comes back — usually repriced to whichever neighbouring code the reviewer thinks was actually performed.
Every code in this group
These codes describe the same broad procedure and differ in one respect each. Each has its own page with its own fee range and coverage notes.
Questions about D5225
D5225 — what is it?
The procedure behind the number is maxillary partial denture, flexible base, filed under prosthodontics, removable.
What is the typical fee for D5225?
The usual range is $1,200–$2,800. Anything well outside it is worth a question rather than an assumption.
Is D5225 a covered benefit?
Usually yes, as major prosthodontic treatment at typically 50% — but coverage turns on your own policy, its annual maximum and any waiting period.
What is the difference between D5225 and D5224?
D5224 is immediate mandibular partial denture, cast metal framework: it specifies a cast metal framework rather than a flexible nylon-type base. Everything else about the appointment is identical, so the record has to show that one detail for D5225 to be the defensible code.
Also known as: partial denture, removable partial, chrome denture, flexible denture, clasps.