D7261 — Primary closure of a sinus perforation
D7261 closes a fresh sinus perforation at the appointment it happened, usually during an upper extraction.
This is one of 18 closely related other oral surgical procedures codes. The treatment is explained in full in the other oral surgical procedures guide — this page is about what makes this particular code different.
The sections that follow deal with the requirements, the fee, the claim, and the neighbouring codes — the last of which is where most of the confusion starts.
The conditions built into D7261
Dentition — a primary (baby) tooth. The restoration only has to survive until the tooth is shed naturally, which changes what counts as adequate treatment and usually rules out the more expensive alternatives.
Told apart from the codes it is confused with
D7260 — Oroantral fistula closure: It closes a hole between the mouth and the sinus that has become an established fistula.
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.
D7261 sits in a group of 18 codes in total; the remainder are linked at the foot of this page. The distinction is clinical, not administrative: each of these describes work that was genuinely done differently, and the fee follows the work.
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 D7261
D7261 — what is it?
Primary closure of a sinus perforation. It belongs to the oral and maxillofacial surgery section of the code set.
What is the typical fee for D7261?
The usual range is $450–$1,200. Anything well outside it is worth a question rather than an assumption.
Will my plan pay for D7261?
Usually yes, as major oral surgery treatment at variable — but coverage turns on your own policy, its annual maximum and any waiting period.
What is the difference between D7261 and D7260?
D7260 is oroantral fistula closure: it closes a hole between the mouth and the sinus that has become an established fistula. They are different operations that happen to sit next to each other in the code set, so one is not an alternative way of billing the other.
Also known as: avulsed tooth, impacted canine exposure, oroantral fistula, salivary stone, vestibuloplasty.