Jaw Surgery: Orthognathic Procedures and the Timeline
Orthognathic surgery repositions the jaws. Where the upper and lower jaws are mismatched in size or position beyond what braces can compensate for — a markedly receding or protruding lower jaw, an open bite that cannot be closed orthodontically, significant facial asymmetry — the bones themselves are cut, moved and fixed in the new position with plates and screws.
What orthognathic surgery involves
Orthognathic surgery repositions the jaws. Where the upper and lower jaws are mismatched in size or position beyond what braces can compensate for — a markedly receding or protruding lower jaw, an open bite that cannot be closed orthodontically, significant facial asymmetry — the bones themselves are cut, moved and fixed in the new position with plates and screws. A LeFort I osteotomy repositions the whole upper jaw. Mandibular ramus osteotomies move the lower jaw forward or back. Segmental and subapical osteotomies move a portion of an arch. Higher-level LeFort II and III procedures address the mid-face and are reserved for major craniofacial conditions.
When this treatment is used
Undertaken for skeletal discrepancies that cause functional problems — difficulty chewing, speech problems, obstructive sleep apnoea, joint strain — and for the facial appearance that accompanies them. Treatment is almost always combined with orthodontics before and after surgery.
The full treatment arc
This is a long process. Typically twelve to eighteen months of braces first, to align each arch and deliberately move the teeth into positions that will only make sense once the jaws are repositioned. Then surgery, under general anaesthetic, with a hospital stay of one to three nights. Then a period of restricted diet and careful jaw use — commonly six weeks — followed by six to twelve months of further orthodontics to finish. Recovery from the surgery itself involves substantial swelling that takes weeks to settle fully, numbness of the lip and chin that is normal initially and resolves over months in most cases, and a soft or liquid diet for several weeks. Patients consistently report that the first fortnight is hard and that they would do it again.
Getting it funded
Orthognathic surgery is a medical claim, and it turns on demonstrating functional impairment rather than appearance. What supports approval: documented difficulty chewing, a measured skeletal discrepancy outside normal ranges, sleep study evidence where apnoea is involved, speech assessment, and confirmation that orthodontics alone cannot correct the problem. Pre-authorisation is essential and denials are common on first submission. Appeals with better documentation frequently succeed. Where the motivation is primarily appearance, it will be treated as cosmetic and excluded — and it is worth being clear-eyed about which side of that line a particular case sits on.
Costs and insurance in summary
Typical fee range across the group: $0–$0 where a single band applies. Several codes here are priced individually and carry their own range on their own page. Surgeon fees only — hospital, anaesthesia, orthodontics and imaging are all additional. Total treatment costs are substantial and usually pursued through medical insurance.
Benefit category: Medical, variable on a typical plan. A medical claim requiring pre-authorisation and documentation of functional impairment. Denials on first submission are common and appeals often succeed.
Common restrictions: Pre-authorisation essential; Functional impairment must be documented — appearance alone will be excluded; Hospital, anaesthesia and orthodontic costs are separate claims; Sleep study evidence strengthens apnoea-related cases.
The codes this guide covers
Each of these describes a variant of the same procedure. Follow a code for its own fee range, its coverage notes and what distinguishes it from the rest of the group.
| Code | Variant | Typical fee |
|---|---|---|
| D7940 | Osteoplasty — for orthognathic deformities | $2,000–$7,000 |
| D7941 | Osteotomy — mandibular rami | $4,000–$12,000 |
| D7943 | Osteotomy — mandibular rami with bone graft | $5,000–$15,000 |
| D7944 | Osteotomy — segmented or subapical | $2,500–$8,000 |
| D7945 | Osteotomy — body of mandible | $4,500–$13,000 |
| D7946 | LeFort I (maxilla — total) — most reported | $5,000–$15,000 |
| D7947 | LeFort I (maxilla — segmented) | $6,000–$18,000 |
| D7948 | LeFort II or LeFort III — without bone graft | $8,000–$25,000 |
| D7949 | LeFort II or LeFort III — with bone graft | $9,000–$28,000 |
| D7991 | Coronoidectomy | $5,000–$15,000 |
Common questions
How long does orthognathic treatment take altogether?
Usually two to three years: twelve to eighteen months of braces first, then surgery, then a further six to twelve months of orthodontics to finish.
Is jaw surgery covered by insurance?
It is a medical claim and turns on documented functional impairment — difficulty chewing, sleep apnoea, a measured skeletal discrepancy. Pre-authorisation is essential and appeals after an initial denial often succeed.
What is recovery from jaw surgery like?
Substantial swelling for weeks, numbness of the lip and chin that usually resolves over months, and a soft or liquid diet for several weeks. Most patients find the first two weeks the hardest.
Can braces fix a jaw discrepancy without surgery?
Sometimes, by compensating with tooth position. Beyond a certain size of skeletal discrepancy the compensation becomes unstable or produces an unacceptable result, and the bones have to be moved.