Getting a dental implant is confusing. You see advertisements for “Implants starting at $999,” so you go in expecting a straightforward bill.
Then, you get the treatment plan. Instead of one line item, you see three or four. There’s the screw, the crown, and then this mysterious line item in the middle: “D6013 – Abutment – includes placement.”
You might be asking yourself: “Wait, I thought I paid for the implant? Why am I being charged hundreds of dollars for a connector piece?”
You are not alone in this frustration. D6013 is one of the most common sources of sticker shock in restorative dentistry. It is the “hidden” middle step of the implant process that often pushes the total cost over your insurance annual maximum.
As a patient, you need to know exactly what you are paying for. This guide isn’t just a clinical definition; it is a financial playbook. We are going to decode the jargon, expose the “missing tooth clauses” insurers use to deny payment, and show you exactly how to finance this expensive procedure—even if your credit isn’t perfect.
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Decoding D6013: What Are You Actually Buying?
To understand the cost, you have to understand the anatomy of a fake tooth. A dental implant isn’t one piece; it is usually three distinct parts, typically billed separately.
1. The Implant Body: This is the screw put into your bone.
2. The Crown: This is the white part you see and chew with.
3. The Abutment (D6013): This is the bridge between the two.
CDT Code D6013 specifically refers to a standard (pre-fabricated) abutment.
Think of the implant body as an anchor buried under the sand. You can’t attach a boat (the crown) directly to an anchor buried deep underground. You need a chain or a post that sticks up above the surface to connect them. D6013 is that post.
Why is it billed separately? Because it is a separate component with its own manufacturing cost and its own procedure time. After your gum heals around the implant screw, the dentist has to reopen the gum, unscrew a protective cap, and screw in this D6013 abutment so the final crown has something to sit on.
The “Standard” vs. “Custom” Trap: D6013 is for a pre-fabricated abutment. It comes in a box in standard sizes. If your situation is complex, your dentist might need a custom abutment (Code D6057). Custom abutments are significantly more expensive. Always ask your dentist: “Are we using a standard D6013 or a custom D6057, and why?”
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The Procedure: What to Expect
If you have already had the implant screw placed, the hard part is over. The placement of the D6013 abutment is usually much easier.
1. Exposure: If your gum has healed over the implant, the dentist makes a tiny incision to find the screw. You will be numbed for this.
2. Removal of Healing Cap: They unscrew the “healing abutment” (a temporary cap used to shape the gum).
3. Placement: They screw the D6013 abutment into the implant body. It is tightened to a specific torque to ensure it never loosens.
4. Impression: Once the D6013 is on, they take a mold or a 3D scan to make your final crown.
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The Financial Reality: Costs, Traps, and Secrets
This is the most critical section. Dental implants are expensive, and D6013 is often the tipping point that maxes out your insurance.
1. Estimated Costs: Cash vs. Insurance
If you have no insurance, the national average for a D6013 abutment typically ranges between $300 and $600 per tooth.
• The Context: Remember, this is just for the connector. The implant screw and the crown are separate charges. The total “Implant Triad” usually costs thousands per tooth.
• Local Prices: Don’t guess. Use the Delta Dental Cost Estimator tool12. By entering your specific ZIP code, you can see the “fair market value” for implant services in your neighborhood. This empowers you to negotiate if a quote seems sky-high2.
2. The “Annual Maximum” Trap
Here is the math problem nobody warns you about: Most dental plans have an annual maximum of $1,000 or $1,5003.
• The Problem: The implant placement (Step 1) likely costs $1,500+. The D6013 Abutment (Step 2) is $500+. The Crown (Step 3) is $1,200+.
• The Result: You will hit your insurance limit before you even get to the D6013 code. You might be 100% out-of-pocket for the abutment and the crown.
• The Solution: You need a high-maximum plan.
◦ Spirit Dental: They offer plans like the “Spirit Pinnacle PPO” that scale up to a $5,000 annual maximum by year three45. This is one of the few plans that gives you enough room to cover the implant, the abutment (D6013), and the crown in a single year.
◦ Cigna: Check out the Cigna Dental 3000/100 plan, which offers up to $3,000 in benefits6. This extra buffer can save you thousands.
3. The “Missing Tooth Clause”
This is the nastiest surprise in dental insurance.
• The Clause: Many plans state that they will not pay to replace a tooth that was missing before you bought the policy.
• The Impact: If you lost the tooth years ago and buy insurance today to get an implant, they might deny the claim for the D6013 abutment entirely.
• The Fix: Read the “Exclusions” carefully78. Some plans may cover this after a waiting period, or specifically exclude it. Always verify “Missing Tooth” coverage before enrolling.
4. The “Waiting Period” Hurdle
Implants and abutments are often considered “Major” services. Standard insurance usually requires you to wait 12 months before they will touch an implant claim910.
• The Hack: If you are ready to start now, standard insurance is useless.
◦ Spirit Dental: They are famous for No Waiting Periods411. You can theoretically get coverage for major services much faster than traditional carriers.
◦ Humana: Look for Loyalty Plus plans12. While they incentivize you to stay longer, they often provide access to benefits without the strict lock-out periods of older plans.
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Financing Options: When You Can’t Pay Upfront
If your insurance denies the D6013 code or you’ve maxed out your benefits, you aren’t out of luck.
1. Dental Savings Plans (The “Loophole”)
If you are facing a Missing Tooth Clause or a Waiting Period:
• What they are: Membership clubs (not insurance)13.
• The Win: They activate instantly. According to Dentaly.org, you can save 10% to 60% on dental care, including implant codes like D601313. Since it’s a discount, there is no “annual maximum” cap. You can get multiple implants in one year, and the discount applies to every single abutment.
2. Third-Party Financing
• Dental Loans & Credit Cards: Dentaly.org highlights that many patients use dental loans or credit cards to manage these costs14.
• Bad Credit: If you don’t qualify for traditional loans, ask about in-house financing. Since implant treatment takes months to complete, many dentists will let you pay in installments (e.g., pay for the screw in January, pay for the D6013 abutment in April).
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Recovery and Aftercare
Placing the D6013 abutment is minor compared to the original implant surgery.
• Pain: You might have slight gum tenderness for 24 hours. Over-the-counter pain relief is usually enough.
• Hygiene: This is critical. You must keep the abutment clean. If bacteria gets between the abutment and the gum, you can get “peri-implantitis,” which causes the whole implant to fail.
• The “Gap”: Once the D6013 is placed, you might have a metal post sticking up in your mouth for a couple of weeks while the lab makes the crown. Be careful not to chew hard food directly on it.
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Frequently Asked Questions (FAQ)
1. Why is the abutment (D6013) billed separately from the implant? Because it is a separate component that requires a separate procedure. The implant body is the “root,” and the abutment is the “connector.” Different manufacturers and sizes mean the dentist has to purchase and place this specific piece distinct from the screw itself.
2. Can I skip D6013 and attach the crown directly to the implant? Generally, no. You need a connector. However, there is a procedure called a “screw-retained crown” where the abutment and crown are fused or integrated. This might be billed differently. Ask your dentist if a screw-retained crown is an option for you.
3. Does insurance cover D6013? It depends. Many “Basic” dental plans exclude implants entirely15. You need a plan that specifically covers “Implant Services.” Even then, check if they cover the abutment or just the surgical placement. Plans like Cigna Dental 15006 or Spirit Pinnacle4 are more likely to have this coverage.
4. What is the difference between D6013 and D6057?
• D6013: Standard, pre-made abutment (Cheaper).
• D6057: Custom-cast abutment made specifically for your gum shape (More expensive). Insurance often “downgrades” D6057 to the price of D6013, leaving you to pay the difference.
5. How much does a D6013 cost without insurance? The abutment alone usually costs several hundred dollars. This does not include the crown that goes on top of it. Use the Delta Dental Cost Estimator to verify prices in your specific ZIP code1.
6. Can I use a Dental Savings Plan for D6013? Yes! This is often the best way to pay for implants. Savings plans usually offer significant discounts on implant codes without asking about missing teeth or waiting periods13.
7. Does the D6013 procedure hurt? Usually, no. The dentist may use a little local anesthesia on the gum, but since the implant itself has no nerves, you won’t feel “tooth pain.” It is much easier than the extraction or the implant placement.
8. How long do I have to wait after the implant to get the D6013 placed? Typically 3 to 6 months. The bone needs to fuse to the implant screw (osseointegration) before you can screw the abutment in and put weight on it.
9. Will the metal abutment show through my gum? If you have thin gums, a metal (titanium) D6013 might show a grey tint. In the “smile zone” (front teeth), dentists often use Zirconia abutments (white) to avoid this. Ask if there is a price difference.
10. What happens if I don’t get the abutment placed? Then you can’t get a tooth. The implant screw will just stay buried in your bone. It won’t hurt you, but it won’t function as a tooth either.
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Conclusion: Don’t Let the “Middle Man” Code Surprise You
Seeing D6013 on your treatment plan is actually a good sign—it means your implant was successful and you are ready for the final restoration steps.
However, the financial side requires vigilance. This little connector piece is expensive and can easily be the straw that breaks your insurance maximum’s back.
• Check your maximums: A standard 1,000limitisn′tenoughforimplants.Considerswitchingtoahigh−limitplanlike∗∗Spirit∗∗(5,000 max) or Cigna ($3,000 max) during open enrollment.
• Watch for clauses: Ensure your plan doesn’t have a “missing tooth clause” that voids coverage.
• Bundle the cost: If insurance fails, Dental Savings Plans are your safety net.
Your new smile is an investment. By understanding what D6013 is, you can ensure you are paying a fair price for the hardware that holds it all together.
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Disclaimer: This article is for informational purposes only and does not constitute medical or financial advice. We are not dentists or insurance agents. Dental codes and insurance benefits vary by year, state, and provider. Always verify coverage with your insurance carrier and consult a licensed professional for treatment.keep_pinNotlara kaydet
