| Rating | |
|---|---|
| 9900 Maxilla or mandible, chronic osteomyelitis or osteoradionecrosis of: | |
| Rate as osteomyelitis, chronic under diagnostic code 5000 | |
| 9901 Mandible, loss of, complete, between angles | 100 |
| 9902 Mandible, loss of approximately one-half: | |
| Involving temporomandibular articulation | 50 |
| Not involving temporomandibular articulation | 30 |
| 9903 Mandible, nonunion of: | |
| Severe | 30 |
| Moderate | 10 |
| Note - Dependent upon degree of motion and relative loss of masticatory function | |
| 9904 Mandible, malunion of: | |
| Severe displacement | 20 |
| Moderate displacement | 10 |
| Slight displacement | 0 |
| Note - Dependent upon degree of motion and relative loss of masticatory function | |
| 9905 Temporomandibular articulation, limited motion of: | |
| Inter-incisal range: | |
| 0 to 10 mm | 40 |
| 11 to 20 mm | 30 |
| 21 to 30 mm | 20 |
| 31 to 40 mm | 10 |
| Range of lateral excursion: | |
| 0 to 4 mm | 10 |
| Note - Ratings for limited inter-incisal movement shall not be combined with ratings for limited lateral excursion | |
| 9906 Ramus, loss of whole or part of: | |
| Involving loss of temporomandibular articulation | |
| Bilateral | 50 |
| Unilateral | 30 |
| Not involving loss of temporomandibular articulation | |
| Bilateral | 30 |
| Unilateral | 20 |
| 9907 Ramus, loss of less than one-half the substance of, not involving loss of continuity: | |
| Bilateral | 20 |
| Unilateral | 10 |
| 9908 Condyloid process, loss of, one or both sides | 30 |
| 9909 Coronoid process, loss of: | |
| Bilateral | 20 |
| Unilateral | 10 |
| 9911 Hard palate, loss of half or more: | |
| Not replaceable by prosthesis | 30 |
| Replaceable by prosthesis | 10 |
| 9912 Hard palate, loss of less than half of: | |
| Not replaceable by prosthesis | 20 |
| Replaceable by prosthesis | 0 |
| 9913 Teeth, loss of, due to loss of substance of body of maxilla or mandible without loss of continuity: | |
| Where the lost masticatory surface cannot be restored by suitable prosthesis: | |
| Loss of all teeth | 40 |
| Loss of all upper teeth | 30 |
| Loss of all lower teeth | 30 |
| All upper and lower posterior teeth missing | 20 |
| All upper and lower anterior teeth missing | 20 |
| All upper anterior teeth missing | 10 |
| All lower anterior teeth missing | 10 |
| All upper and lower teeth on one side missing | 10 |
| Where the loss of masticatory surface can be restored by suitable prosthesis | 0 |
| Note - These ratings apply only to bone loss through trauma or disease such as osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease, since such loss is not considered disabling | |
| 9914 Maxilla, loss of more than half: | |
| Not replaceable by prosthesis | 100 |
| Replaceable by prosthesis | 50 |
| 9915 Maxilla, loss of half or less: | |
| Loss of 25 to 50 percent: | |
| Not replaceable by prosthesis | 40 |
| Replaceable by prosthesis | 30 |
| Loss of less than 25 percent: | |
| Not replaceable by prosthesis | 20 |
| Replaceable by prosthesis | 0 |
| 9916 Maxilla, malunion or nonunion of: | |
| Severe displacement | 30 |
| Moderate displacement | 10 |
| Slight displacement | 0 |