D5955 — Palatal lift prosthesis, definitive
D5955 is the palatal lift, which holds a paralysed soft palate up so that speech is not nasal and food does not escape into the nose.
eleven codes describe obturator and resection prosthesis, and this is one of them. What separates it from the other ten is the subject of this page; the obturator and resection prosthesis guide covers the treatment itself.
Read on for the conditions this code carries, the money involved, the way a payer is likely to treat it, and a plain comparison against each of the codes it is easily mistaken for.
The conditions built into D5955
Arch — upper. The palate provides broad support for anything removable, but the sinuses sit directly above the back teeth, which constrains surgical work.
D5955 compared with its closest relatives
D5954 — Palatal augmentation prosthesis: It builds the palate up so that the tongue can reach it, which improves speech and swallowing where tongue movement is limited.
D5958 — Palatal lift prosthesis, interim: It is the interim version.
D5959 — Palatal lift prosthesis, modification: It is the same procedure with one word changed: modification rather than definitive.
D5937 — Trismus appliance (not for TMD treatment): It is the trismus appliance, used to stretch a mouth that cannot open — for scarring or radiotherapy rather than for TMD.
D5955 sits in a group of eleven codes in total; the remainder are linked at the foot of this page. A plan reads these codes as definitions, not as descriptions. If the notes for the visit do not match D5955 exactly, the claim is assessed as whichever of these the notes do match.
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 D5955
What is D5955 on my dental bill?
D5955 records palatal lift prosthesis, definitive — one of the maxillofacial prosthetics codes.
What should I expect to pay for D5955?
$1,500–$6,000 is the realistic range before benefits. Your own share depends on your plan's percentage, deductible and remaining annual maximum.
Will my plan pay for D5955?
Yes on most policies, treated as medical / maxillofacial work at variable. A waiting period on a new policy is the commonest reason it is not.
What is the difference between D5955 and D5954?
D5954 is palatal augmentation prosthesis: it builds the palate up so that the tongue can reach it, which improves speech and swallowing where tongue movement is limited. The two are neighbours by number rather than by treatment, so seeing both on a plan usually means both were genuinely planned.
Also known as: obturator, palatal defect, oral cancer prosthesis, maxillary resection, speech aid.