Billing Code Overview

CDT code D7210 describes an extraction of an erupted tooth that requires removal of bone and/or sectioning of the tooth and includes elevation. The procedure includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of socket bone, and closure.

Service Type: Oral and Maxillofacial Surgery (dental surgical procedure)

Typical Site of Service: Dental Office (POS 11)

Clinical Context

A 32-year-old patient presents to a dental office (POS 11) with pain and difficulty chewing related to a fully erupted but structurally compromised molar. Clinical exam and radiographs demonstrate extensive tooth structure loss with periodontal involvement and possible periapical pathology. After local anesthesia, the oral and maxillofacial surgeon or dentist performs a surgical extraction requiring removal of alveolar bone and sectioning of the tooth to facilitate removal. The procedure includes elevation, cutting of gingiva and bone as needed, removal of tooth structure, minor smoothing of the socket bone, and closure. Typical workflow: evaluation and radiographs, informed consent, local anesthesia (with or without sedation per practice policies), surgical extraction documented as CDT code D7210, intraoperative findings and technique recorded, postoperative instructions and analgesia provided, and follow-up arranged for healing assessment.

Coding Specifications

• Common Modifiers

• 22 - Increased Procedural Services: Use when the work required to perform the surgical extraction is substantially greater than typically required for CDT code D7210, and appropriate supporting documentation describes and justifies the increased effort.

• 52 - Reduced Services: Use when the surgical extraction described by CDT code D7210 is partially reduced or eliminated at the physician’s or dentist’s discretion; documentation must note the reduced nature of the service.

• Associated Provider Taxonomies

• 1223S0112X — Oral and Maxillofacial Surgery: Specialists trained in surgical management of the oral and maxillofacial region who commonly perform surgical extractions like D7210.

• 1223G0001X — General Practice Dentist: General dentists who may perform surgical extractions in the dental office setting when within their scope.

• 1223D0001X — Dentist: Providers licensed as dentists who may perform or coordinate the procedure in an office setting.

Related Diagnoses

• K01.1 — Impacted teeth

  • Relevance: Impacted teeth can necessitate surgical extraction techniques that may require removal of bone or sectioning, making this diagnosis relevant to D7210 when an erupted tooth is complicated by impaction or partial impaction.

• K08.1 — Loss of teeth due to accident, extraction, or local periodontal disease

  • Relevance: This code captures tooth loss scenarios where extraction is performed; D7210 may be billed when removal of a compromised erupted tooth involves surgical measures.

• K04.7 — Periapical abscess without sinus

  • Relevance: Periapical infection can compromise tooth structure or surrounding bone, leading to surgical extraction approaches consistent with D7210.

• K05.6 — Periodontal disease, unspecified

  • Relevance: Advanced periodontal disease may result in tooth mobility or bone loss requiring extraction; when surgical removal with bone modification is needed, D7210 may be appropriate.

• K12.2 — Cellulitis and abscess of mouth

  • Relevance: Oral cellulitis or abscesses can necessitate surgical intervention including extraction with bone removal; documentation should link the acute infectious process to the need for D7210.

Related Codes

• D7140 - Extraction, erupted tooth or exposed root (elevation and/or forceps removal)

  • Clinical relationship: D7140 is used for non-surgical extractions performed with elevation or forceps without removal of bone or sectioning; it is an alternative when bone removal/sectioning is not required.

• D7220 - Removal of impacted tooth - soft tissue

  • Clinical relationship: D7220 applies to impacted teeth covered only by soft tissue; it may be used instead of D7210 when the tooth is impacted under soft tissue rather than erupted and requiring bone removal.

• D7230 - Removal of impacted tooth - partially bony

  • Clinical relationship: D7230 is used when partial bone removal is required for an impacted tooth; it may be an alternative when impaction and partial bony coverage define the clinical problem.

• D7240 - Removal of impacted tooth - completely bony

  • Clinical relationship: D7240 applies to teeth completely encased in bone and typically requires more extensive bone removal than D7210.

• D7250 - Removal of residual tooth roots (cutting procedure)

  • Clinical relationship: D7250 is used when residual roots require sectioning and removal; it can follow an extraction or be used when roots remain after crown removal.

• Common usage notes: D7140 is commonly used as an alternative for simple non-surgical extractions. Codes D7220–D7240 and D7250 represent procedural variations for impacted teeth or residual roots and may be chosen based on impaction depth and extent of bone removal. Documentation should support the selected code and any modifier (for example, 22 or 52).

National mean commercial rates exceed Medicare in the provided benchmarks: BUCA (average commercial) has a mean of $146.49 compared with Medicare (no Medicare value provided in the input). UnitedHealthcare and Blue Cross Blue Shield report the highest commercial mean rates at $198.47 and $171.56 respectively, while Cigna Health and Aetna report lower means at $102.72 and $125.97 respectively.

Rate dispersion (P75 minus P25) is widest for Blue Cross Blue Shield (203.00 − 130.00 = $73.00) and UnitedHealthcare (225.22 − 174.67 = $50.55). Dispersion is tightest for Cigna Health (111.00 − 96.00 = $15.00) and Aetna (135.50 − 98.33 = $37.17). The table and chart below present the full breakdown.