D5226 — Mandibular partial denture — flexible base
D5226 is a lower partial denture with a flexible nylon base instead of rigid acrylic or cast metal.
There are 13 codes for partial denture and they are not interchangeable. This page covers this one; the partial denture guide covers the treatment they all share.
The sections that follow deal with the requirements, the fee, the claim, and the neighbouring codes — the last of which is where most of the confusion starts.
The conditions built into D5226
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 D5226 is only the right code if that is what was actually used.
Arch — lower. The bone is denser, but there is far less surface area to support anything removable and the nerve running through the jaw limits how aggressive surgery can be.
D5226 against the codes beside it
D5225 — Maxillary partial denture — flexible base: It is the upper-jaw version.
D5227 — Immediate maxillary partial denture — flexible base: It is the upper-jaw version.
D5224 — Immediate mandibular partial denture — cast metal framework: It specifies a cast metal framework rather than a flexible nylon-type base.
D5228 — Immediate mandibular partial denture — flexible base: It is the interim version.
D5226 sits in a group of 13 codes in total; the remainder are linked at the foot of this page. The safest question to ask is not "what does this cost" but "which code is going on the claim". The first answer changes; the second decides the first.
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 D5226
D5226 — what is it?
It is the prosthodontics, removable code for mandibular partial denture, flexible base, and it means that specific procedure and no other.
How much does D5226 cost?
$1,200–$2,800 covers most of the country. Specialist practices and big-city addresses tend to sit in the upper half.
How do dental plans handle D5226?
It normally falls under major prosthodontic cover, typically 50%. Whether a particular claim is paid depends more on your history with the plan than on the code.
What is the difference between D5226 and D5225?
D5225 is maxillary partial denture, flexible base: it is the upper-jaw version. The rest of the procedure is the same, which is why the two get substituted for one another on estimates.
Also known as: partial denture, removable partial, chrome denture, flexible denture, clasps.