D7260 — Oroantral fistula closure
D7260 closes a hole between the mouth and the sinus that has become an established fistula.
This code belongs to a set of 18 covering other oral surgical procedures. The clinical detail lives in the other oral surgical procedures guide; the code-level detail is here.
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.
Not to be confused with
D7261 — Primary closure of a sinus perforation: It closes a fresh sinus perforation at the appointment it happened, usually during an upper extraction.
D7270 — Tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth: It puts a knocked-out or displaced tooth back into its socket and splints it while the ligament heals.
D7280 — Exposure of an unerupted tooth (surgical access): It surgically uncovers a tooth that has not come through, so that it can erupt or be brought into line.
D7283 — Placement of device to facilitate eruption of impacted tooth: It bonds a bracket or chain onto an exposed impacted tooth so that an orthodontist can pull it into position.
D7260 sits in a group of 18 codes in total; the remainder are linked at the foot of this page. 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.
Questions about D7260
D7260 — what is it?
Oroantral fistula closure, reported under a single oral and maxillofacial surgery code.
What is the typical fee for D7260?
Typically $700–$1,900 before insurance, depending on local fees and the complexity of the individual case.
Will my plan pay for D7260?
Yes on most policies, treated as major oral surgery work at variable. A waiting period on a new policy is the commonest reason it is not.
What is the difference between D7260 and D7261?
D7261 is primary closure of a sinus perforation: it closes a fresh sinus perforation at the appointment it happened, usually during an upper extraction. They share a section of the code set and very little else, so the comparison worth making is on what each involves rather than on which is cheaper.
Also known as: avulsed tooth, impacted canine exposure, oroantral fistula, salivary stone, vestibuloplasty.