The CDT codes oral surgery practices report sit in the D7000 to D7999 range, the Oral and Maxillofacial Surgery category of the ADA's Code on Dental Procedures and Nomenclature. Inside that range, extractions run D7111 through D7251, alveoloplasty D7310 through D7321, biopsies D7285 through D7288, and grafts, frenectomies and repairs D7910 through D7999. Sedation is not in there. It lives in the D9000 series and is reported separately. Getting the boundaries between these blocks right removes most surgical denials before they happen.
What are CDT codes in dental?
CDT is the Code on Dental Procedures and Nomenclature, maintained by the American Dental Association and named under HIPAA as the standard code set for dental claims. Every entry is the letter D plus four digits, a short nomenclature, and often a longer descriptor stating what has to be true for the code to apply. That descriptor is the part billers skip and payers read.
The set is divided into twelve categories of service, and the digit after the D tells you which: D0 diagnostic, D1 preventive, D2 restorative, D3 endodontics, D4 periodontics, D5 removable and maxillofacial prosthetics, D6 implants and fixed prosthodontics, D7 oral and maxillofacial surgery, D8 orthodontics, D9 adjunctive general services.
Two rules matter more than the rest. Codes are added, revised and deleted every year effective January 1, so you report the version in force on the date of service. And CDT codes are also HCPCS Level II codes, which is why a D code can appear on a CMS-1500 medical claim when the case is medically indicated.
The D7000 series, block by block
| Range | What it covers | Representative codes |
|---|---|---|
| D7111 to D7140 | Non-surgical extractions | D7111 coronal remnants, primary tooth. D7140 erupted tooth or exposed root |
| D7210 to D7251 | Surgical extractions, impactions, residual roots | D7210, D7220, D7230, D7240, D7241, D7250, D7251 |
| D7260 to D7297 | Other surgical procedures | D7280 exposure of an unerupted tooth. D7285 and D7286 incisional biopsy |
| D7310 to D7321 | Alveoloplasty, per quadrant | D7310 and D7311 with extractions. D7320 and D7321 without |
| D7340 to D7350 | Vestibuloplasty | Ridge extension procedures |
| D7410 to D7465 | Excision and destruction of lesions | Benign and malignant, by size and tissue |
| D7471 to D7490 | Excision of bone tissue | D7471 lateral exostosis. D7472 torus palatinus. D7473 torus mandibularis |
| D7510 to D7560 | Surgical incision | D7510 intraoral incision and drainage. D7560 maxillary sinusotomy |
| D7610 to D7780 | Fractures, simple and compound | Maxilla, mandible, malar, alveolus |
| D7810 to D7899 | Temporomandibular joint procedures | D7870 arthrocentesis. D7880 occlusal orthotic device |
| D7910 to D7999 | Repairs, grafts and other | D7953 ridge preservation graft. D7960 frenulectomy. D7999 unspecified, by report |
Two rows catch practices out. Alveoloplasty is priced per quadrant and split by tooth count, one to three spaces versus four or more. And D7953, bone replacement graft for ridge preservation, is billed per site, meaning per socket, not per visit.
Extraction codes, where the narrative does the work
This is the block that carries the volume and the disputes. These codes are not separated by how long the case took. They are separated by anatomy and technique, and the operative note has to say which.
| Code | Nomenclature in short | What the record must show |
|---|---|---|
| D7140 | Extraction, erupted tooth or exposed root | Elevation and forceps removal, no flap, no bone removal |
| D7210 | Surgical extraction, erupted tooth | Removal of bone, sectioning of the tooth, or elevation of a mucoperiosteal flap |
| D7220 | Removal of impacted tooth, soft tissue | Occlusal surface covered by soft tissue, flap elevated |
| D7230 | Removal of impacted tooth, partially bony | Part of the crown covered by bone, bone removed |
| D7240 | Removal of impacted tooth, completely bony | Most or all of the crown covered by bone |
| D7241 | Completely bony, unusual surgical complications | Nerve proximity or dissection, aberrant position, sinus involvement |
| D7250 | Removal of residual tooth roots | Cutting procedure on roots retained from a prior extraction |
| D7251 | Coronectomy, intentional partial tooth removal | Crown removed, roots deliberately retained, with the reason stated |
The most common downcode in this range is D7210 paid at the D7140 rate, and it happens when the narrative reads "surgical extraction of tooth 19" and nothing else. Write the technique instead: flap elevated, buccal bone removed with a surgical handpiece, tooth sectioned, sutures placed. That sentence is the difference between the two codes.
The second most common is D7240 paid as D7230. Bony coverage is a radiographic finding, so attach the pre-operative image and reference it in the note. When the same downcode keeps landing on the same plan, treat it as a pattern: reducing dental insurance claim denials covers how to work it at that level.
Impactions, sedation cases and large grafts are also the procedures most likely to need review before treatment, and requirements vary by plan. See oral surgery and prior auths for the sequence that gets approvals back faster.
What are the CPT codes for oral surgery?
CPT is the American Medical Association's code set for medical claims, and oral surgery maps into it unevenly. Some procedures have a clean equivalent, some have none.
| Procedure | Typical CPT entry |
|---|---|
| Excision of torus mandibularis | 21031 |
| Excision of maxillary torus palatinus | 21032 |
| Alveoloplasty | 41874 |
| Excision of labial or buccal frenum | 40819 |
| Vestibuloplasty | 40840 to 40845 |
| Dentoalveolar procedure with no listed CPT | 41899, unlisted |
| Maxillofacial CT without contrast | 70486 |
Extractions have no true CPT counterpart, which is why the D code itself is reported on medical claims through HCPCS Level II. Medical claims also need an ICD-10-CM diagnosis, for example K01.1 for impacted teeth, plus a narrative tying it to medical necessity. For Medicare enrollment, CMS uses specialty code 19 for oral surgery performed by dentists and 85 for maxillofacial surgery. Whether a case belongs on the dental claim, the medical claim, or both in sequence depends on the patient's plans, and the differences between CDT and CPT codes in dentistry walk through that decision.
What is CDT code D0367?
D0367 is cone beam CT capture and interpretation with a field of view of both jaws, with or without the cranium. It belongs to diagnostic imaging, not to the surgical range, and it turns up constantly on surgical cases because impaction and implant planning both use it. The capture codes are separated by field of view, and choosing the wrong one is an easy denial:
| Code | Field of view |
|---|---|
| D0364 | Limited field, less than one whole jaw |
| D0365 | One full dental arch, mandible |
| D0366 | One full dental arch, maxilla, with or without cranium |
| D0367 | Both jaws, with or without cranium |
| D0368 | Temporomandibular joint series, two or more exposures |
Capture and interpretation are bundled in these codes, so a signed written interpretation has to exist in the chart. Frequency limits and outright exclusions for cone beam imaging are common and vary by plan, so confirm coverage in advance rather than assuming an indicated scan is payable.
What is CDT code D2952 used for?
D2952 is a post and core in addition to a crown, indirectly fabricated, meaning the post and core are made as one unit in a laboratory. It is restorative, not surgical, which surprises people who meet it on a plan where the tooth was retained rather than extracted. The code it gets confused with is D2954, the prefabricated post and core, where a manufactured post is cemented and the core is built up chairside. Different technique, different code, different fee. D2953 and D2957 cover each additional post in the same tooth.
Plans apply their own rules here, including bundling the buildup into the crown allowance. Those provisions are chosen by the employer group, so they differ from plan to plan under the same carrier name and have to be verified per patient.
Sedation and anesthesia are coded separately
Anesthesia is not part of the surgical fee in CDT. It is adjunctive, in the D9000 series, billed alongside the D7 code.
| Code | What it reports |
|---|---|
| D9219 | Evaluation for moderate sedation, deep sedation or general anesthesia |
| D9222 | Deep sedation or general anesthesia, first 15 minutes |
| D9223 | Deep sedation or general anesthesia, each subsequent 15 minute increment |
| D9230 | Inhalation of nitrous oxide, analgesia, anxiolysis |
| D9239 | Intravenous moderate sedation, first 15 minutes |
| D9243 | Intravenous moderate sedation, each subsequent 15 minute increment |
The CDT code oral sedation practices need is D9248, non-intravenous conscious sedation. Unlike the intravenous and general anesthesia codes, D9248 carries no time increments. It is reported once for the appointment regardless of how long the sedation lasted, so it cannot be stacked for a long case.
For the time-based codes, document start and stop times, agents and doses, and the monitoring record. Plans that pay for sedation generally tie it to the surgery performed under it, and a sedation line with no qualifying surgical line on the same claim tends to be denied.
Before the claim goes out
Four checks catch most of what comes back.
- Match the code to the note, not the fee schedule. If the note does not describe bone removal, sectioning or a flap, D7210 will not hold.
- Attach the image you are relying on. Impaction level, residual roots and cone beam capture are all radiographic claims.
- Name the quadrant, the site and the tooth number. Alveoloplasty is per quadrant, ridge preservation per site, extractions per tooth.
- Send the sedation line with its surgical line. Same claim, same date, times documented.
At volume this checking stops being feasible by hand, and the choice is adding staff, sending the work out, which outsourcing dental billing weighs honestly, or automating it. Curo reads each surgical claim against the note and the plan's rules before submission and flags the missing radiograph or the narrative that will not carry the code, the part of claims automation that pays for itself on one D7240.
Whichever route you take, the discipline does not change. The code is a claim about what happened in the operatory, and the record either supports it or it does not.