Endodontic microsurgery cost guide

How Much Does an Apicoectomy Cost?

An apicoectomy, or root-end surgery, commonly costs $900-$2,500 per tooth before separate imaging, sedation, biopsy, or restorative fees. It is usually considered when infection persists after root canal treatment and nonsurgical retreatment is unsuitable or has not resolved the problem.

Content revised ·Pricing and editorial methodology

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Planning estimate

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Typical planning range

$900-$2,500 per tooth

Typical midpoint

$1,700

Itemized cost range

ComponentExpected rangePlanning note
Consultation and X-rays$100-$350Specialist evaluation
CBCT$200-$600When three-dimensional imaging is needed
Apicoectomy$900-$2,500Root-end surgery and seal
Sedation$300-$1,200Optional and provider dependent
Pathology$100-$400When tissue is submitted

What is usually included?

  • Local anesthesia
  • Surgical access
  • Removal of infected tissue and root tip
  • Root-end preparation and filling
  • Sutures and routine review

What may be charged separately?

  • CBCT
  • Sedation
  • Biopsy/pathology
  • Crown repair or replacement
  • Nonsurgical retreatment performed first

What changes the price?

  • Tooth location and surgical access
  • Number of roots treated
  • Existing post, crown, or bridge
  • Size and nature of the lesion
  • Microsurgical equipment and specialist fees

Example treatment plans

Accessible anterior tooth

Consultation, surgery and routine follow-up

$1,100-$2,200

Complex posterior case

CBCT, microsurgery, sedation and pathology

$2,000-$4,000+

Insurance considerations

Plans may classify apicoectomy as endodontic surgery and apply specialist coinsurance, deductibles, and annual maximums.

Verify whether prior retreatment, CBCT, sedation, and pathology are separate eligible services.

Dentist insight

How to read this quote

Compare an apicoectomy quote with the full alternative pathway, not with a primary root canal fee. The decision may involve nonsurgical retreatment, surgery, or extraction. Existing posts, crowns, bridgework, lesion location, and restorability influence which route is practical.

Questions to ask before accepting the quote

  • Why is surgery preferred over nonsurgical retreatment?
  • Does the fee include CBCT and root-end filling?
  • Could the existing crown or bridge be damaged?
  • Is pathology included if tissue is removed?
  • What is the extraction-and-replacement alternative?

Relevant alternatives

  • Nonsurgical root canal retreatment
  • Extraction and implant
  • Extraction and bridge
  • Monitoring when the endodontist considers it appropriate

Reading a quote for root canal treatment line by line

The label on a quote tells you less than the lines beneath it. Check the same tooth, the same provider type, and whether the final restoration is included, and make sure that anything not included is stated rather than assumed.

If a line is vague, ask the office to define it. Reputable practices are used to explaining their quotes, and a written breakdown protects both sides.

  • Look for items listed as 'additional' or 'if needed'
  • Ask what could change the total and by how much
  • Confirm the warranty in writing
  • Keep a copy of every estimate you receive

Insurance and timing

Plans vary in how they classify root canal treatment, and the crown that follows is often a separate claim with its own limits. A waiting period or annual maximum can affect when and how treatment is scheduled.

Pain and infection should not wait. If a tooth is infected, ask the office about the fastest option and whether a payment plan is available.

What affects the cost of a root canal

The tooth being treated is the biggest factor. Front teeth usually have one canal, while molars can have three or four and take longer and require more skill, which is why molar treatment typically costs more. A previously treated tooth that needs retreatment is also more complex.

The provider matters as well. A general dentist can treat many teeth, while an endodontist specializes in root canal work and may be recommended for difficult anatomy or retreatment. Specialist fees are often higher, but they can be appropriate for complex cases.

What the treatment involves

The dentist numbs the tooth, removes the infected or damaged pulp, cleans and shapes the canals and seals them. The tooth is then restored, usually with a crown for a back tooth, because a treated tooth can be more brittle.

Many root canals are completed in one or two visits. Mild soreness afterwards is common and usually settles with simple pain relief, but ongoing or worsening symptoms should be reported.

What a root canal quote should include

A quote for the root canal alone is not the full cost of keeping the tooth. Ask what is and is not included.

  • The tooth and the number of canals expected
  • Imaging and the emergency or exam fee
  • A build-up and the crown that usually follows
  • Any referral to an endodontist
  • A follow-up visit and what happens if the tooth needs retreatment

Root canal compared with extraction

Keeping a natural tooth is often preferable if it can be saved. Extraction is usually cheaper on the day, but replacing the tooth with an implant, a bridge or a denture can cost more over time and affects neighboring teeth.

Your dentist can explain whether the tooth is restorable. A tooth with extensive decay, a vertical fracture or severe gum loss may not be a good candidate.

Next, root canal cost guide, root canal cost calculator, root canal costs by tooth, and root canal retreatment costs are good places to continue. Each page uses the same planning approach, so figures and questions carry over.

Sources and methodology

These are broad educational planning ranges, not provider quotes. We separate procedure components so unlike treatment packages are not presented as equivalent. Actual fees depend on diagnosis, technique, materials, provider, benefits, and location.

Read the pricing and editorial methodology

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