D7650 — Malar and/or zygomatic arch — open reduction
One of the codes covering the surgical treatment of facial fractures and associated wounds. D7650 is the open-reduction version for the cheekbone.
It is one of 24 codes covering facial fracture treatment and wound repair. For the procedure itself rather than the code, see the facial fracture treatment and wound repair guide; for the code, read on.
Below is what the code actually specifies, the fee range to expect, how dental benefits normally handle it, and the specific differences between it and the codes it is most often confused with.
What has to be true for D7650 to apply
Bone — the cheekbone and its arch. The zygoma forms the prominence of the cheek and the outer wall of the eye socket. Displacement shows up as a flattened cheek, a step in the orbital rim, numbness of the cheek and upper lip, and sometimes double vision — which is why these are assessed for the eye as much as for the bone.
Technique — open reduction. The bone is exposed through an incision so the fractured ends can be seen and held directly, usually with plates and screws. It is the more involved of the two approaches and the one used when the fragments will not line up any other way, when they are displaced, or when several pieces are involved. It carries the higher fee of the pair for that reason.
Fracture type — simple (closed). The overlying skin and mucosa are intact, so the fracture site is not contaminated. These are the lower-numbered fracture codes and the lower fees; the same bone treated as a compound fracture has a separate code higher in the range.
Told apart from the codes it is confused with
D7640 — Mandible — closed reduction (teeth immobilized, if present): It is the same procedure on the lower jaw rather than the cheekbone, and by closed reduction rather than open.
D7660 — Malar and/or zygomatic arch — closed reduction: It is the closed-reduction version of the same injury — the fragments are set without exposing the bone, which is why it is the cheaper of the two.
D7630 — Mandible — open reduction (teeth immobilized, if present): It is the same procedure on the lower jaw rather than the cheekbone.
D7670 — Alveolus — closed reduction, may include stabilization of teeth: It is the same procedure on the tooth-bearing ridge rather than the cheekbone, and by closed reduction rather than open.
D7650 sits in a group of 24 codes in total; the remainder are linked at the foot of this page. 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.
Questions about D7650
What procedure is D7650?
It is the oral and maxillofacial surgery code for malar and/or zygomatic arch, open reduction, and it means that specific procedure and no other.
What is the typical fee for D7650?
Usually somewhere in $2,000–$9,000 as a gross fee. The code fixes what was done, not what it costs, so ask for the practice's own figure in writing.
Is D7650 a covered benefit?
Yes on most policies, treated as medical / oral surgery work at variable. A waiting period on a new policy is the commonest reason it is not.
What is the difference between D7650 and D7640?
D7640 is mandible, closed reduction, teeth immobilized, if present: it is the same procedure on the lower jaw rather than the cheekbone, and by closed reduction rather than open. Because that is the only difference, a reviewer who disagrees with it simply reprices the claim to D7640 rather than refusing it.
Also known as: jaw fracture, facial trauma, open reduction, closed reduction, maxillofacial injury.