D4249 — Clinical crown lengthening (hard tissue)
D4249 removes bone to expose more of a tooth, so that a crown has enough structure to hold on to.
It is one of three codes covering periodontal flap surgery and osseous surgery. For the procedure itself rather than the code, see the periodontal flap surgery and osseous surgery guide; for the code, read on.
What the code requires, what it costs, how it is paid, and how to tell it from its neighbours — each in its own section below.
Told apart from the codes it is confused with
D4240 — Gingival flap surgery with root planing (4+ teeth): It lifts the gum away so that the root surfaces can be cleaned under direct vision, without reshaping any bone.
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 D4249 are the whole group — nothing else describes this procedure. None of these are interchangeable, even though they sound as though they might be. Checking that the code on your estimate is the one that matches the planned treatment takes a minute and prevents most billing surprises.
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 |
|---|---|
| D4249 | Clinical crown lengthening (hard tissue) — this page |
| D4240 | Gingival flap surgery with root planing (4+ teeth) |
| D4260 | Osseous surgery (4+ teeth per quadrant) |
Questions about D4249
What procedure is D4249?
Clinical crown lengthening, hard tissue, reported under a single periodontics code.
Is D4249 expensive?
Typically $800–$1,900 before insurance, depending on local fees and the complexity of the individual case.
Does dental insurance cover D4249?
Typically, yes — major periodontal benefits, typically 50%. What varies between plans is the frequency limit rather than whether the procedure is covered at all.
Also known as: gum surgery, flap surgery, osseous surgery, crown lengthening, pocket reduction.