D4260 — Osseous surgery (4+ teeth per quadrant)
D4260 reshapes the bone around the teeth as well as cleaning them, eliminating the pockets rather than simply cleaning them out.
Among the three codes in this group it is the workhorse — the one most practices report by default. The procedure behind it is explained at length in the periodontal flap surgery and osseous surgery guide.
This page sets out the conditions the code carries, what practices charge for it, how a plan is likely to assess it, and the named difference between it and each of its neighbours.
The specifics of D4260
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.
Counted — per quadrant. Treating the whole mouth produces four separate line items, and most plans cap how many quadrants they will pay for at one visit.
How D4260 differs from its neighbours
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.
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.
Those two codes and D4260 are the whole group — nothing else describes this procedure. It is worth asking the practice to point to which of these applies. The fees are not close, and the wording is, which is precisely the combination that produces disputed bills.
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 |
|---|---|
| D4260 | Osseous surgery (4+ teeth per quadrant) — this page |
| D4240 | Gingival flap surgery with root planing (4+ teeth) |
| D4249 | Clinical crown lengthening (hard tissue) |
Questions about D4260
What does dental code D4260 mean?
Read literally, D4260 means osseous surgery, 4+ teeth per quadrant — and payers do read it literally.
What is the typical fee for D4260?
Usually somewhere in $900–$2,200 as a gross fee. The code fixes what was done, not what it costs, so ask for the practice's own figure in writing.
How do dental plans handle D4260?
Most plans include it under major periodontal benefits, typically 50%. A pre-treatment estimate is the only way to know your own number in advance.
Also known as: gum surgery, flap surgery, osseous surgery, crown lengthening, pocket reduction.