CDT Code D4268

Official Description

Surgical revision procedure, per tooth

This procedure is to refine the results of a previously provided surgical procedure. This may require a surgical procedure to modify the irregular contours of hard or soft tissue. A mucoperiosteal flap may be elevated to allow access to reshape alveolar bone. The flaps are replaced or repositioned and sutured.

Short Descr	Surgical revision procedure, per tooth
Medium Descr	Surgical revision procedure, per tooth

D4210-D4999 V. Periodontics

D4210-D4286 Surgical Services (Including Usual Postoperative Care)

D4210 Gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant

D4211 Gingivectomy or gingivoplasty - one to three contiguous teeth or tooth bounded spaces per quadrant

D4212 Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth

D4230 Anatomical crown exposure - four or more contiguous teeth or tooth bounded spaces per quadrant

D4231 Anatomical crown exposure - one to three teeth or tooth bounded spaces per quadrant

D4240 Gingival flap procedure, including root planing - four or more contiguous teeth or tooth bounded spa

D4241 Gingival flap procedure, including root planing - one to three contiguous teeth or tooth bounded spa

D4245 Apically positioned flap

D4249 Clinical crown lengthening - hard tissue

D4260 Osseous surgery (including elevation of a full thickness flap and closure) - four or more contiguous

D4261 Osseous surgery (including elevation of a full thickness flap and closure) - one to three contiguous

D4263 Bone replacement graft - retained natural tooth - first site in quadrant

D4264 Bone replacement graft - retained natural tooth - each additional site in quadrant

D4265 Biologic materials to aid in soft and osseous tissue regeneration, per site

D4266 Guided tissue regeneration, natural teeth – resorbable barrier, per site

D4267 Guided tissue regeneration, natural teeth – non-resorbable barrier, per site

D4268 Surgical revision procedure, per tooth

D4270 Pedicle soft tissue graft procedure

D4273 Autogenous connective tissue graft procedure (including donor and recipient surgical sites) first to

D4274 Mesial/distal wedge procedure, single tooth (when not performed in conjunction with surgical procedu

D4275 Non-autogenous connective tissue graft (including recipient site and donor material) first tooth, im

D4276 Combined connective tissue and pedicle graft, per tooth

D4277 Free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant

D4278 Free soft tissue graft procedure (including recipient and donor surgical sites) each additional cont

D4283 Autogenous connective tissue graft procedure (including donor and recipient surgical sites) - each a

D4285 Non-autogenous connective tissue graft procedure (including recipient surgical site and donor materi

D4286 Removal of non-resorbable barrier

Code	Description

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CDT Code D4268

Official Description

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