D4240 — Gingival flap surgery with root planing (4+ teeth)
D4240 lifts the gum away so that the root surfaces can be cleaned under direct vision, without reshaping any bone.
three codes describe periodontal flap surgery and osseous surgery, and this is one of them. What separates it from the other two is the subject of this page; the periodontal flap surgery and osseous surgery guide covers the treatment itself.
Everything below is specific to this code: what it pins down, what it is worth, how a payer handles it, and which codes it is not.
What has to be true for D4240 to apply
Extent — four or more teeth in the quadrant. Four or more teeth means the appointment covered a whole quadrant rather than an isolated problem area, which is what separates this code from its lower-count sibling and accounts for most of the fee difference.
Where the line falls between D4240 and the rest
D4249 — Clinical crown lengthening (hard tissue): It removes bone to expose more of a tooth, so that a crown has enough structure to hold on to.
D4260 — Osseous surgery (4+ teeth per quadrant): It reshapes the bone around the teeth as well as cleaning them, eliminating the pockets rather than simply cleaning them out.
Those two codes and D4240 are the whole group — nothing else describes this procedure. Where the codes sit this close together, the record of the appointment is what settles which one was earned. That is worth knowing before treatment rather than after.
Every code in this group
These codes describe the same broad procedure and differ in one respect each. Each has its own page with its own fee range and coverage notes.
| Code | Procedure |
|---|---|
| D4240 | Gingival flap surgery with root planing (4+ teeth) — this page |
| D4249 | Clinical crown lengthening (hard tissue) |
| D4260 | Osseous surgery (4+ teeth per quadrant) |
Questions about D4240
What does dental code D4240 mean?
Read literally, D4240 means gingival flap surgery with root planing, 4+ teeth — and payers do read it literally.
What should I expect to pay for D4240?
Most private fees fall in $700–$1,600. Geography accounts for more of that spread than anything clinical.
Is D4240 a covered benefit?
Plans generally pay it as major periodontal treatment, typically 50%, subject to whatever is left of your maximum for the year.
Also known as: gum surgery, flap surgery, osseous surgery, crown lengthening, pocket reduction.