D5227 — Immediate 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. D5227 is the immediate 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.
What the number specifies, what it costs, what your plan is likely to do with it, and the named differences between it and the codes around it — in that order.
The specifics of D5227
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 D5227 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.
Status — interim, not definitive. It is built to function for a limited period while something else is planned or healing, and many plans fold its fee into the definitive restoration if that follows within a few months.
D5227 compared with its closest relatives
D5226 — Mandibular partial denture — flexible base: It is the lower-jaw version.
D5228 — Immediate mandibular partial denture — flexible base: It is the lower-jaw version.
D5225 — Maxillary partial denture — flexible base: It is the definitive version.
D5224 — Immediate mandibular partial denture — cast metal framework: It specifies a cast metal framework rather than a flexible nylon-type base.
D5227 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 D5227 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 D5227
D5227 — what is it?
The procedure behind the number is immediate maxillary partial denture, flexible base, filed under prosthodontics, removable.
How much does D5227 cost?
Typically $1,200–$2,800 before insurance, depending on local fees and the complexity of the individual case.
Is D5227 a covered benefit?
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 D5227 and D5226?
D5226 is mandibular partial denture, flexible base: it is the lower-jaw version. Nothing else separates them, which is exactly why a claim submitted under the wrong one of the two is such a common correction.
Also known as: partial denture, removable partial, chrome denture, flexible denture, clasps.