D7509 — Marsupialization of odontogenic cyst
D7509 marsupialises a cyst instead of removing it: the cyst is opened and left draining so that it shrinks before any definitive surgery.
This is one of eight closely related cyst and tumour removal codes. The treatment is explained in full in the cyst and tumour removal 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.
Told apart from the codes it is confused with
D7490 — Radical resection of maxilla or mandible: It is radical resection of part of the upper or lower jaw, the major cancer-surgery code in this range.
D7530 — Removal of foreign body — from mucosa, skin, or subcutaneous alveolar tissue: It removes a foreign body lodged in gum, skin or the soft tissue over the jaw.
D7540 — Removal of reaction-producing foreign bodies — musculoskeletal system: It removes foreign material that is provoking a reaction in muscle or bone, which is deeper and more involved work.
D7461 — Removal of benign nonodontogenic cyst or tumor — greater than 1.25 cm: It removes a non-odontogenic benign cyst or tumour larger than 1.25 centimetres.
D7509 sits in a group of eight codes in total; the remainder are linked at the foot of this page. Reviewers compare the narrative against the code rather than the other way round, so the question worth asking is what the notes will say.
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 D7509
What procedure is D7509?
D7509 is shorthand for marsupialization of odontogenic cyst — the same five characters every practice and every insurer in the country uses for it.
How much does D7509 cost?
$600–$1,600 covers most of the country. Specialist practices and big-city addresses tend to sit in the upper half.
Will my plan pay for D7509?
In most cases yes, at the major oral surgery / medical rate: variable. The annual maximum is what usually decides how much of that you actually see.
What is the difference between D7509 and D7490?
D7490 is radical resection of maxilla or mandible: it is radical resection of part of the upper or lower jaw, the major cancer-surgery code in this range. 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: jaw cyst, odontogenic cyst, ameloblastoma, marsupialisation, jaw tumour.