Flipper ADA Code: The Hidden Revenue Killer & How Smart Dentists Are Fixing It
PPOs Are Ripping You Off on Flippers – Here’s How to Win Instead Flipper ADA Code: Dentists, let’s get something straight: You’re losing money on flippers. You do the work. You bill the Flipper ADA Code (D5820 for upper, D5821 for lower) and… BAM! PPOs cut your fee in half faster than you can say “insurance […]
By Jordon ComstockFebruary 17, 2025Updated September 13, 20264 min read
PPOs Are Ripping You Off on Flippers – Here’s How to Win Instead
Flipper ADA Code: Dentists, let’s get something straight: You’re losing money on flippers.
You do the work. You bill the Flipper ADA Code (D5820 for upper, D5821 for lower) and… BAM! PPOs cut your fee in half faster than you can say “insurance is a scam.”
Meanwhile, your front desk is on hold (again) trying to fight yet another claim denial.
Sound familiar?
Fact: The average dental practice writes off $35,000+ per month due to PPO discounts.
Fact: That’s $420,000 per year—money you EARNED but never see.
❌ Why are you still letting insurance dictate your profits?
❌ Why are you waiting months to get underpaid?
❌ Why are you stressed about case acceptance when patients NEED treatment?
Here’s the truth: Smart practice owners aren’t playing the PPO game anymore. They’re growing their practice the right way—with membership patients who pay directly.
Keep reading to learn how you can:
✅ Ditch PPOs & build a thriving membership plan.
✅ Stop chasing insurance & start generating predictable, recurring revenue (MRR & ARR).
✅ Turn flipper patients into HIGH-VALUE, long-term members.
Let’s dive in.
Story: What is the Flipper ADA Code & Why Are You Losing Money on It?
What is a Flipper?
A flipper is a removable partial denture that replaces one or more missing teeth. It’s usually a temporary solutionwhile a patient waits for:
✅ Dental Implants
✅ Permanent Partial Dentures
✅ Bridges
ADA Codes for Flippers:
D5820 – Upper Partial Denture (Flipper)
D5821 – Lower Partial Denture (Flipper)
These are common procedures, but they come with a huge problem—insurance reimbursements SUCK.
The PPO Problem: You’re Getting Paid Pennies for Flippers
What a Flipper Should Be Worth: $800 – $1,500
What Most PPOs Pay: $300 – $600
That means for every 10 flippers you deliver, you’re losing $5,000+ per month.
The True Cost of PPO Write-Offs:
You see 30 flipper patients a month
PPOs underpay by $500 per case
$15,000 lost PER MONTH
$180,000 PER YEAR—GONE!
And that’s just one procedure. Multiply this across crowns, dentures, and implants, and you’ll see why most practices struggle with profitability.
So, what’s the fix? Stop relying on PPOs & start offering a membership plan.
How a Membership Plan Turns Flipper Patients Into Revenue Machines
The Problem:
Most uninsured patients can’t afford flippers outright. Meanwhile, insurance patients are stuck in PPO restrictions.
Here’s what happens when you rely on insurance:
❌ Patients delay treatment due to high out-of-pocket costs.
❌ Insurance rejects the claim or covers only a fraction.
❌ You’re left fighting PPOs for months just to get underpaid.
The Solution? A Membership Plan.
Instead of waiting for PPO scraps, why not have patients enroll in a direct-pay membership plan?
How a Membership Plan Works for Flipper Patients:
✅ Patients pay a low monthly or annual fee for basic & restorative care.
✅ They get discounts on major procedures (including flippers, dentures, and implants).
✅ You generate predictable monthly recurring revenue (MRR).
✅ No insurance headaches. No claim denials. Just direct payment.
Why This Works:
✔️ Membership patients spend 2X-4X more than PPO patients.
✔️ They stay LOYAL because they’re financially committed.
✔️ Your practice has recurring revenue—NO MORE rollercoaster months.
How much could you make?
If you sign up just 300 patients at $35/month…
That’s $10,500/month in guaranteed revenue (MRR).
That’s $126,000/year in additional revenue (ARR).
And that’s BEFORE they say yes to flippers, implants, or other treatments!
Want an easy way to manage memberships? Check out BoomCloud™ Click Here
Epiphany Bridge: How One Dentist Scaled to $500K in Recurring Revenue
Dr. Mike Johnson was tired of PPOs dictating his income.
What He Did:
✔️ Launched a BoomCloud™ membership plan for patients needing flippers, dentures, and implants.
✔️ Included discounts on removable prosthetics in the plan.
✔️ Marketed the plan through direct mail, social media, & in-office promotions.
Results in 12 Months:
1,200 patients joined his membership plan.
MRR hit $41,000/month.
ARR grew to $492,000/year.
Now, Dr. Johnson has predictable revenue, loyal patients, and NO PPO headaches.
Want the same results? Check out BoomCloud™
Final Thoughts: Stop Letting PPOs Control Your Income
Here’s Your 3-Step Plan to Take Back Control:
Step 1: Identify Your PPO Write-Offs.
Find out how much money you’re losing every month.
Step 2: Launch a Membership Plan for Patients Needing Flippers & Restorative Care.
Give them affordable, predictable care WITHOUT insurance restrictions.
Step 3: Use BoomCloud™ to Track & Grow Your Membership Program.
Automate billing, renewals, and revenue tracking.
More revenue. More patient loyalty. Less stress.
Ready to build a membership plan that scales? Check out BoomCloud™ and start making your practice insurance-free.
Resources & Further Reading:
BoomCloudApps.com – The #1 tool for launching & managing dental membership plans.
ADA Practice Report – Industry trends & insights on PPO reimbursement rates.
DentistryIQ – Expert tips for growing a profitable dental practice.
Final Thought: PPOs are stealing your profits. Smart dentists ditch insurance and build predictable, recurring revenue.
The future of dentistry is membership-based. Are you ready to take control of your revenue? Start today with BoomCloud™.
Ready to replace PPO write-offs with recurring revenue? See how practices use BoomCloud membership software for dental practices to build in-house membership plans.