D4264 — Bone graft around a natural tooth (additional site)
Regenerative periodontal procedures attempt to rebuild what the disease destroyed, rather than reshaping around it.
It is one of five codes covering periodontal grafting and regeneration. For the procedure itself rather than the code, see the periodontal grafting and regeneration guide; for the code, read on.
The rest of this page deals with the specifics: the requirements written into the code, the usual range of fees, the typical benefit outcome, and how to tell it apart from its closest relatives.
Reading D4264
Sequence — an "each additional" code. D4264 never appears on its own. It follows the primary code for the same procedure at the same visit and carries a lower fee. A claim showing it without a matching primary code above it will be rejected.
Counted — per site rather than per tooth. What counts as a single site is the detail that gets argued about on these claims.
Not to be confused with
D4263 — Bone graft around a natural tooth (first site): It is the primary line this one follows.
D4266 — Guided tissue regeneration — resorbable membrane: It is the primary line this one follows.
D4267 — Guided tissue regeneration — non-resorbable membrane: It is the primary line this one follows.
D4273 — Connective tissue graft (gum graft): It is the primary line this one follows.
Those four codes and D4264 are the whole group — nothing else describes this procedure. The practical point: confirm which of these is going on the claim before treatment, not after. Corrections after submission mean a resubmission, a delay, and occasionally a fee you did not expect.
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 |
|---|---|
| D4264 | Bone graft around a natural tooth (additional site) — this page |
| D4263 | Bone graft around a natural tooth (first site) |
| D4266 | Guided tissue regeneration — resorbable membrane |
| D4267 | Guided tissue regeneration — non-resorbable membrane |
| D4273 | Connective tissue graft (gum graft) |
Questions about D4264
D4264 — what is it?
D4264 is shorthand for bone graft around a natural tooth, additional site — the same five characters every practice and every insurer in the country uses for it.
What is the typical fee for D4264?
Usually somewhere in $300–$800 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 D4264?
Usually yes, as major periodontal treatment at 0–50% — but coverage turns on your own policy, its annual maximum and any waiting period.
What is the difference between D4264 and D4263?
D4263 is bone graft around a natural tooth, first site: it is the primary line this one follows. Apart from that, the two describe the same treatment — which is why the notes for the visit matter more here than the code itself.
Also known as: gum graft, bone graft, guided tissue regeneration, receding gums, connective tissue graft.