What is the D4260 dental code?

It's osseous (bone) surgery on four or more teeth in a quadrant — a periodontal procedure that lifts a gum flap to reshape the bone and reduce deep pockets in advanced gum disease.

How is osseous surgery different from a deep cleaning?

A deep cleaning (scaling and root planing) is non-surgical. Osseous surgery (D4260) is a surgical step that opens the gum and reshapes the bone when deep cleaning hasn't controlled the disease.

What's the difference between D4260 and D4261?

Both are osseous surgery per quadrant. D4260 is four or more teeth; D4261 is one to three teeth in a quadrant.

Does insurance cover osseous surgery?

Usually under periodontal benefits at around half after the deductible, with perio charting and X-rays. Plans typically require prior non-surgical therapy and limit frequency, often with pre-authorization.

Why reshape the bone?

Recontouring the bone reduces the deep pockets where disease thrives, making the area easier to keep clean and helping stop further bone loss.

D4260 Dental Code: Osseous (Gum) Surgery Cost

Code Summary

D4260 is the CDT code for osseous (bone) surgery on four or more teeth in a quadrant — a periodontal procedure that reshapes the bone and reduces deep gum pockets in advanced gum disease. It's a surgical step beyond deep cleaning.

What D4260 means

D4260 covers osseous surgery, including flap entry and closure, for four or more contiguous teeth or tooth-bounded spaces in a quadrant. "D" is dental, "42" is the periodontal surgery group, and "60" is this osseous surgery. The surgeon lifts a gum flap to access the bone, then reshapes the underlying bone to eliminate the deep pockets where periodontal disease thrives.

It's used for advanced gum disease that hasn't resolved with non-surgical treatment like scaling and root planing. By recontouring the bone and reducing pocket depth, it makes the area easier to keep clean and helps halt the progression of bone loss.

Like scaling and root planing, it's reported per quadrant, with D4260 for four or more teeth and D4261 for one to three teeth in a quadrant. It's a more involved surgical procedure than a deep cleaning, requires perio charting and X-rays to justify, and plans usually limit it to once per quadrant in a multi-year window.

When it's typically used

D4260 is reported when advanced periodontal disease in a quadrant (four or more teeth) requires surgical access to reshape the bone and reduce deep pockets, after non-surgical treatment hasn't fully controlled the disease.

How much does D4260 cost?

Osseous surgery is a significant surgical fee, billed per quadrant, often roughly 1,000 to 2,000 USD per quadrant depending on region and severity. Treating multiple quadrants multiplies the cost.

Is D4260 covered by insurance?

Covered under periodontal/major benefits when documented with perio charting and X-rays showing bone loss and deep pockets, often around half after the deductible. Plans usually require prior non-surgical therapy and limit it to once per quadrant in a multi-year period; pre-authorization is common.

Frequently asked questions

What is the D4260 dental code?: It's osseous (bone) surgery on four or more teeth in a quadrant — a periodontal procedure that lifts a gum flap to reshape the bone and reduce deep pockets in advanced gum disease.
How is osseous surgery different from a deep cleaning?: A deep cleaning (scaling and root planing) is non-surgical. Osseous surgery (D4260) is a surgical step that opens the gum and reshapes the bone when deep cleaning hasn't controlled the disease.
What's the difference between D4260 and D4261?: Both are osseous surgery per quadrant. D4260 is four or more teeth; D4261 is one to three teeth in a quadrant.
How much does D4260 cost?: Often around 1,000 to 2,000 USD per quadrant depending on location and severity. Multiple quadrants multiply the cost.
Does insurance cover osseous surgery?: Usually under periodontal benefits at around half after the deductible, with perio charting and X-rays. Plans typically require prior non-surgical therapy and limit frequency, often with pre-authorization.
Why reshape the bone?: Recontouring the bone reduces the deep pockets where disease thrives, making the area easier to keep clean and helping stop further bone loss.

This page is an independent, plain-language explanation for general information only. It is not billing, coding, or clinical advice. For the official CDT descriptor and current-year wording, refer to the American Dental Association.