What D7948 means

D7948 covers a LeFort II or LeFort III osteotomy (described as osteoplasty of facial bones for midface hypoplasia or retrusion) — without bone graft. "D" is dental, "79" is this oral surgery area, and "48" is this LeFort II/III without graft. The LeFort levels (I, II, III) are progressively higher osteotomy lines across the midface (named from the classic LeFort fracture patterns): LeFort I is low (across the maxilla above the teeth); LeFort II is higher (a pyramidal cut involving the maxilla and the nasal/orbital region — the nose and central midface move with the maxilla); and LeFort III is highest (separating the entire midface/facial bones from the cranial base — the maxilla, cheekbones (zygomas), and nose all move together — 'craniofacial disjunction'). So D7948 is a high-level midface osteotomy (LeFort II or III) to advance/reposition the midface, without a bone graft.

So it's a major midface osteotomy — repositioning more of the facial skeleton (the central or entire midface) — for significant midface deficiency, done without a bone graft.

LeFort II and III osteotomies are more extensive than the LeFort I — they reposition larger portions of the facial skeleton, used for significant midface deformities, particularly midface hypoplasia or retrusion (a markedly underdeveloped or set-back midface) — often associated with congenital/craniofacial conditions (e.g., syndromic craniofacial conditions like certain craniosynostosis syndromes) or major deformities. LeFort II advances the central midface (maxilla + nose), and LeFort III advances the entire midface (maxilla + cheekbones + nose) — bringing a deficient midface forward to correct the facial proportions, the airway, the eye support, and the bite. These are major craniofacial procedures (more complex than orthognathic LeFort I surgery), often done by/with craniofacial surgeons. D7948 is the version without a bone graft; when the advancement creates gaps that need bone grafting (common with large midface advancements), the graft version (D7949) is used instead. The code covers the osteotomy/repositioning of the facial bones. It's done under general anesthesia. It's performed by an oral and maxillofacial / craniofacial surgeon. These procedures are medically necessary (correcting significant functional/structural deformities), so medical coverage applies. This code is in the orthognathic/craniofacial surgery area (D7940-D7949). Documentation supports the claim.

When it's typically used

D7948 is reported for a LeFort II or LeFort III osteotomy without a bone graft — higher-level osteotomies of the midface/facial bones — used to correct significant midface deformities (midface hypoplasia or retrusion — a markedly underdeveloped/set-back midface, often congenital/craniofacial). LeFort II/III reposition more of the facial skeleton than a LeFort I. This is the version without a graft (D7949 is the with-graft version).

How much does D7948 cost?

A LeFort II or III osteotomy is a major craniofacial surgical procedure (under general anesthesia, in a hospital) — more extensive than a LeFort I — so its cost is substantial, typically in the multiple-thousands range or higher. Sample fee-schedule values are in the four-figure range (varying widely by region/case/complexity). As these correct significant deformities, they're medically necessary and medical coverage applies. Verify your specific coverage.

Is D7948 covered by insurance?

LeFort II/III osteotomies correct significant midface deformities (often congenital/craniofacial, with functional impacts on the bite, breathing/airway, and eye support) — so they're medically necessary and covered under medical benefits (these are major craniofacial reconstructions). Documentation of the deformity (the midface hypoplasia/retrusion), the functional impairment, and the medical necessity is essential, and preauthorization is required. The distinction from D7949 is the absence of a bone graft. Verifying coverage helps.

The LeFort levels: I, II, III

Higher LeFort levels involve more of the midface, and understanding this clarifies the code.

Understanding the LeFort levels clarifies D7948. The LeFort classification (from the classic patterns of midface fracture) describes horizontal levels across the midface, used for osteotomy lines: LeFort I — the lowest level: a horizontal cut across the maxilla above the tooth roots (separating the tooth-bearing maxilla) — repositions the upper jaw (the standard orthognathic maxillary osteotomy, D7946/D7947); LeFort II — a higher, pyramidal level: the cut runs up through the maxilla and across the nasal bridge and the lower orbital (eye socket) region — so the central midface (the maxilla together with the nose) is separated and can be moved as a unit; and LeFort III — the highest level: the cut separates the entire midface from the cranial base ('craniofacial disjunction') — the maxilla, the cheekbones (zygomas), and the nose all together — so the whole midface can be advanced.

So as the level goes from I to III, progressively more of the facial skeleton is included and moved. LeFort II and III (this code) are the higher, more extensive levels — repositioning large portions of the midface (vs the LeFort I, which just moves the tooth-bearing maxilla). So D7948 covers the higher (II/III) LeFort osteotomies. Understanding this helps patients see that the LeFort classification (from the classic patterns of midface fracture) describes horizontal levels across the midface used for osteotomy lines — LeFort I (the lowest level: a horizontal cut across the maxilla above the tooth roots, separating the tooth-bearing maxilla, repositioning the upper jaw, the standard orthognathic maxillary osteotomy D7946/D7947), LeFort II (a higher, pyramidal level: the cut running up through the maxilla and across the nasal bridge and the lower orbital/eye-socket region, so the central midface — the maxilla together with the nose — is separated and moved as a unit), and LeFort III (the highest level: the cut separating the entire midface from the cranial base, 'craniofacial disjunction' — the maxilla, the cheekbones/zygomas, and the nose all together — so the whole midface can be advanced) — so as the level goes from I to III progressively more of the facial skeleton is included and moved, LeFort II and III (this code) being the higher, more extensive levels (vs the LeFort I, which just moves the tooth-bearing maxilla).

Correcting midface hypoplasia/retrusion

These osteotomies advance a deficient midface, and understanding this clarifies the indication.

Understanding the indication clarifies D7948. LeFort II/III osteotomies are used for significant midface deformities — particularly midface hypoplasia (underdevelopment of the midface) or retrusion (a midface set too far back). In these conditions, the middle of the face (the area around the upper jaw, cheeks, and nose, below the eyes) is deficient or recessed — which can cause: a concave facial profile / flat midface — the midface doesn't project as it should (the eyes/forehead may appear prominent relative to the recessed midface); a malocclusion — often the upper jaw is set back relative to the lower (an underbite-like relationship from the maxillary/midface deficiency); airway/breathing problems — the midface deficiency can narrow the airway (nasal/pharyngeal) — a significant functional concern (e.g., in some craniofacial syndromes); and eye/orbital concerns — in higher deformities, the eye support/position can be affected.

Such significant midface deficiency is often part of congenital/craniofacial conditions (e.g., syndromic craniosynostosis like Crouzon or Apert syndrome, or other craniofacial anomalies). The LeFort II/III osteotomy advances the deficient midface forward — bringing the midface (central or whole) into better position — correcting the facial proportions, the bite, the airway, and the orbital/eye support as applicable. So D7948 corrects significant midface deficiency by advancing the midface. Understanding this helps patients see that LeFort II/III osteotomies are used for significant midface deformities — particularly midface hypoplasia (underdevelopment) or retrusion (a midface set too far back) — in which the middle of the face (around the upper jaw, cheeks, and nose, below the eyes) is deficient or recessed, which can cause a concave facial profile/flat midface (the midface not projecting as it should, the eyes/forehead appearing prominent relative to the recessed midface), a malocclusion (often the upper jaw set back relative to the lower, an underbite-like relationship from the maxillary/midface deficiency), airway/breathing problems (the midface deficiency narrowing the nasal/pharyngeal airway, a significant functional concern, e.g., in some craniofacial syndromes), and eye/orbital concerns (in higher deformities, the eye support/position affected) — such significant deficiency often part of congenital/craniofacial conditions (e.g., syndromic craniosynostosis like Crouzon or Apert syndrome, or other anomalies) — so the LeFort II/III osteotomy advances the deficient midface forward (bringing the central or whole midface into better position), correcting the facial proportions, the bite, the airway, and the orbital/eye support as applicable.

Without bone graft (vs D7949)

This code is the non-grafted version, and understanding this clarifies the distinction.

Understanding the 'without bone graft' part clarifies the difference between D7948 and D7949. The LeFort II/III osteotomy comes in two coded versions, distinguished by whether a bone graft is included: without bone graft (D7948, this code) — the osteotomy and repositioning without grafting; and with bone graft (D7949) — the same, but including a bone graft. Why grafting often matters here: advancing the midface (especially large advancements in LeFort II/III) creates gaps where the bones were separated and moved forward — these gaps may need bone grafting to fill them, support the advanced position, and promote healing/stability. So bone grafting is commonly part of these large midface advancements.

D7948 is used when the procedure is done without a bone graft, and D7949 when a bone graft is included. The choice reflects whether grafting was part of the surgery (which depends on the size of the advancement and the surgeon's plan — large advancements often need grafting, so D7949 is frequently applicable, but D7948 covers the cases done without grafting). The surgeon codes D7948 or D7949 based on whether a graft was used. So D7948 is the LeFort II/III without a bone graft. Understanding this helps patients see that the LeFort II/III osteotomy comes in two coded versions distinguished by whether a bone graft is included — without bone graft (D7948, this code: the osteotomy and repositioning without grafting) and with bone graft (D7949: the same but including a bone graft) — grafting often mattering here because advancing the midface (especially large advancements in LeFort II/III) creates gaps where the bones were separated and moved forward, gaps that may need bone grafting to fill them, support the advanced position, and promote healing/stability (so bone grafting is commonly part of these large midface advancements) — D7948 used when the procedure is done without a graft and D7949 when a graft is included, the choice reflecting whether grafting was part of the surgery (depending on the size of the advancement and the surgeon's plan, large advancements often needing grafting so D7949 is frequently applicable, but D7948 covering cases done without grafting), the surgeon coding D7948 or D7949 based on whether a graft was used.

Where D7948 fits in the codes

D7948 is a high-level midface osteotomy code, and understanding this clarifies the coding.

Understanding where D7948 sits clarifies the coding. D7948 is among the orthognathic/craniofacial surgery codes (D7940-D7949) — at the high end (the most extensive midface osteotomies): the LeFort maxillary/midface osteotomies progress: LeFort I (D7946 total, D7947 segmented) — repositioning the tooth-bearing maxilla (standard orthognathic surgery); and LeFort II or III (D7948 without bone graft, D7949 with bone graft) — the higher midface osteotomies (more of the facial skeleton, for significant midface deformities — more into the realm of craniofacial surgery). The mandibular osteotomies are D7941-D7945.

So D7948/D7949 are the codes for the major midface (LeFort II/III) advancements — distinguished from the LeFort I (D7946/D7947) by involving more of the facial skeleton, and from each other by the bone graft (D7948 without, D7949 with). D7948 specifically is the LeFort II/III without a graft. The surgeon codes D7948 (or D7949 with a graft) for these higher midface osteotomies, used for the significant (often congenital/craniofacial) midface deformities they address. So D7948 is the LeFort II/III without graft among the orthognathic/craniofacial codes. Understanding this helps patients see that D7948 is among the orthognathic/craniofacial surgery codes (D7940-D7949) at the high end (the most extensive midface osteotomies) — the LeFort maxillary/midface osteotomies progressing from LeFort I (D7946 total, D7947 segmented: repositioning the tooth-bearing maxilla, standard orthognathic surgery) to LeFort II or III (D7948 without bone graft, D7949 with bone graft: the higher midface osteotomies, more of the facial skeleton, for significant midface deformities, more into the realm of craniofacial surgery), with the mandibular osteotomies being D7941-D7945 — so D7948/D7949 are the codes for the major midface (LeFort II/III) advancements (distinguished from the LeFort I D7946/D7947 by involving more of the facial skeleton, and from each other by the bone graft: D7948 without, D7949 with), D7948 specifically being the LeFort II/III without a graft, coded (or D7949 with a graft) for these higher midface osteotomies used for the significant, often congenital/craniofacial midface deformities they address.

Frequently asked questions

What is the D7948 dental code?

It's a LeFort II or LeFort III osteotomy — without bone graft — higher-level osteotomies of the midface/facial bones (above the LeFort I level), used to correct significant midface deformities (midface hypoplasia or retrusion — a markedly underdeveloped/set-back midface). LeFort II/III reposition more of the facial skeleton than a LeFort I. This is the version without a bone graft.

What's the difference between LeFort I, II, and III?

They're progressively higher osteotomy levels across the midface. LeFort I (low) moves just the tooth-bearing maxilla. LeFort II (higher, pyramidal) moves the central midface — the maxilla together with the nose. LeFort III (highest) separates and moves the entire midface — the maxilla, cheekbones, and nose — from the cranial base. Higher levels involve more of the facial skeleton.

What does it correct?

Significant midface hypoplasia (underdevelopment) or retrusion (a set-back midface) — often part of congenital/craniofacial conditions. Advancing the deficient midface forward corrects the flat/concave facial profile, the malocclusion (the upper jaw/midface set back), airway/breathing problems (a narrowed airway from the deficiency), and eye/orbital support in higher deformities.

How is it different from D7949?

The difference is the bone graft. D7948 is the LeFort II/III without a bone graft. D7949 is the LeFort II/III with a bone graft. Large midface advancements often create gaps needing grafting (so D7949 is frequently applicable), but D7948 covers the cases done without grafting. The surgeon codes based on whether a graft was used.

How is this different from regular orthognathic surgery?

A LeFort I (regular orthognathic maxillary surgery) repositions the tooth-bearing upper jaw. LeFort II/III are more extensive craniofacial procedures involving larger portions of the facial skeleton (the central or whole midface), for significant deformities often associated with craniofacial syndromes — typically done by/with craniofacial surgeons. They're a step beyond standard jaw surgery in scope.

What does it cost, and is it covered?

It's a major craniofacial surgery (under general anesthesia, in a hospital), more extensive than a LeFort I — cost is substantial, typically multiple thousands or higher. As these correct significant deformities (often congenital, with functional impacts), they're medically necessary and covered under medical benefits (preauthorization required). Verify your specific coverage.

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.