Gingivectomy, excision gingival, each quadrant Gingivoplasty, each quadrant

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1 Dental in Nature Oral Surgery Effective CDT D3410 surgery - anterior D3421 surgery bicuspid (first root) D3425 surgery molar (first root) D3426 D3427 surgery (each additional root) Periradicular surgery without apicoectomy D3428 Bone graft in conjunction with periradicular surgery per tooth, single si te D3429 Bone graft in conjunction with periradicular surgery each additional contiguous tooth in the same surgical si te D3430 retrograde filling per tooth D3431 D3432 D3450 D3460 D3470 D3920 Biologic materials to aid in soft and osseous ti ssue regeneration in conjunction with periradicular surgery Guided ti ssue regeneration, resorbable barrier, per site, in periradicular surgery root amputation - per root endodontic endosseous implant intentional reimplantation (including necessary splinting) hemisection (including any root removal), not including root canal therapy D4210 gingivectomy or gingivoplasty - four or more contiguous teeth or bounded teeth spaces per D4211 gingivectomy or gingivoplasty - one to three teeth, per Gingivectomy, excision gingival, each Gingivoplasty, each Gingivectomy, excision gingival, each Gingivoplasty, each

2 D4212 D4220 D4240 D4241 Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth gingival curettage, surgical per, by report (Deleted 1/01/03) gingival flap procedure, including root planing - four or more contiguous teeth or bounded teeth spaces per gingival flap procedure, including root planing - one to three teeth, per Gingivectomy, excision gingival, each Gingivoplasty, each D4245 apically positioned flap D4260 osseous surgery (including flap entry and closure) - four or more contiguous teeth or bounded teeth spaces per Alveoloplasty, each (specify) D4261 osseous surgery (including flap entry and closure) - one to three teeth, per D4263 bone replacement graft - fi rst in D4264 bone replacement graft - each additional si te in D4265 D4266 D4267 D4268 D4270 D4271 D4273 D4274 biologic materials to aid in soft and osseous ti ssue regeneration guided tissue regeneration - resorbable barrier, per si te guided tissue regeneration - nonresorbable barrier, per si te (includes membrane removal) surgical revision procedure, per tooth pedicle soft ti ssue graft procedure free soft ti ssue graft procedure (including donor si te surgery) subepithelial connective ti ssue graft procedures distal or proximal wedge procedure (when not performed in conjunction with surgical procedures in the same anatomical area) Alveoloplasty, each Alveoloplasty, each (specify) Operculectomy, excision of pericoronal ti ssues D4275 soft ti ssue allograft

3 D4276 combined connective ti ssue and double pedicle graft D4277 free soft ti ssue graft procedure (including donor si te surgery), first tooth or edentulous tooth position in a graft D4278 free soft ti ssue graft procedure (including donor si te surgery), each additional contiguous tooth or edentulous tooth position in a graft D4283 autogenous connective ti ssue graft procedure (including donor and recipient surgical sites) each additional contiguous tooth, implant or edentulous tooth position in same graft si te D4285 Non-autogenous connective tissue graft procedure (including recipient surgical si te and donor material) each additional contiguous D6100 Implant removal, by report D6101 Debridement of a periimplant defect and surface cleaning of exposed implant surfaces, including flap entry and closure D6102 Debridement and osseous contouring of a periimplant defect; includes surface cleaning of exposed implant surfaces and flap entry and cl osure D6103 Bone graft for repair of periimplant defect not including flap entry and closure or, when indicated, placement of a barrier membrane or biologic materials to aid in osseous regeneration D6104 Bone graft at time of implant placement D7210 surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth. D7220 removal of impacted tooth - soft ti ssue D7230 removal of impacted tooth - partially bony D7240 removal of impacted tooth - completely bony

4 D7241 removal of impacted tooth - completely bony, with unusual surgical complications. D7250 surgical removal of residual tooth roots (cutting procedure) D7251 Coronectomy - intentional partial tooth removal D7260 oroantral fistula closure Repair fistula, oromaxillary (combine with if antroto included) D7261 primary closure of a sinus perforation Repair fistula, oromaxillary (combine with if antroto included) D7272 D7280 D7282 D7290 D7291 D7310 D7311 D7320 D7321 D7340 D7350 tooth transplantation (includes reimplantation from one si te to another and splinting and/or stabilization) surgical access of an unerupted tooth mobilization of erupted or malpositioned tooth to aid eruption surgical repositioning of teeth transseptal fiberotomy/supra crestal fiberotomy, by report alveoloplasty in extractions - per alveoloplasty in extractions one to three teeth or tooth spaces, per alveoloplasty not in extractions - per alveoloplasty not in extractions one to three teeth or tooth spaces, per vestibuloplasty ridge extension (secondary epithelialization) vestibuloplasty - ridge extension (including soft ti ssue grafts, muscl e reattachment, revision of soft ti ssue attachment and management of hypertrophied and hyperplastic tissue) Alveoloplasty, each Alveoloplasty, each Vestibuloplasty; anterior Vestibuloplasty; posterior, Vestibuloplasty; unilateral/posterior, Vestibuloplasty; bilateral/entire arch Vestibuloplasty, complex (including ridge extension, muscl e repositioning)

5 D7471 removal of lateral exostosis (maxilla and mandible) Excision of osseous tuberosities, dentoalveolar structure D7472 removal of torus palatinus Excision of maxillary torus palatinus D7473 D7485 D7953 removal of torus mandibularis surgical reduction of osseous tuberosity bone replacement graft for ridge preservation per si te Excision of torus mandibular Excision of osseous tuberosities, dentoalveolar structure D7960 Frenulectomy (frenectomy or frenotomy) - separate procedure 40806, 40819, 41010, 41115, Incision of labial frenum (frenotomy) Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) Incision of lingual frenum (frenotomy) Excision of lingual frenum (frenectomy) D7963 frenuloplasty Frenoplasty (surgical revision of frenum, e.g., with Z-plasty) D7970 D7971 D7972 excision of hyperplastic ti ssue - per arch excision of pericoronal gingiva surgical reduction of fibrous tuberosity Excision of hyperplastic alveolar mucosa, each Operculectomy, excision of pericoronal ti ssues Excision of fibrous tuberosities, dentoalveolar structures

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