Create account

Published September 2026

1 of 6Deep pockets between the gum and the root hold tartar that cleaning tools cannot reach
  1. Deep pockets between the gum and the root hold tartar that cleaning tools cannot reach
  2. The area is numbed
  3. The gum edge is gently eased back so the root is in plain view
  4. The root is cleaned directly, and rough bone is smoothed
  5. The gum is laid back down and held with fine stitches
  6. As it heals the gum tightens and the pockets get shallower

Who usually does it

periodontist. General dentists refer most gum surgery to a periodontist.

One question worth asking

How many areas are being treated, and how many visits does that take?

Healing membrane, dissolving type

Cleanings and gum careMajorD4266

D4266. A barrier placed over a graft that dissolves on its own.

When deep cleaning is not enough, the gum is lifted back so the dentist can clean the roots directly, reshape or graft the bone, and then stitch the gum back in place. Codes differ by how many teeth are treated, whether bone is reshaped, and whether a bone graft or healing membrane is added.

The gum is numbed and lifted back as a flap so the roots and the bone underneath can be cleaned and shaped directly, then it is stitched back into place. Some codes add bone graft material or a healing membrane so bone can fill in. Work is measured one quarter of the mouth at a time or by site, so a mouth treated in sections shows up as several lines. Most plans file this as Major. What they actually pay varies by plan.

Codes for this

D4240MajorGum flap surgery, four or more teethThe gum is lifted to clean the roots directly, without reshaping bone.per quadrant · Done sometimesD4241MajorGum flap surgery, one to three teethThe same flap surgery for a smaller area.per quadrant · Done sometimesD4245MajorGum flap moved lower on the toothThe gum is stitched back at a lower position to shrink pockets.per quadrant · Rarely doneD4260MajorGum and bone surgery, four or more teethFlap surgery that also reshapes the bone around the teeth; the most common gum surgery code.per quadrant · Done sometimesD4261MajorGum and bone surgery, one to three teethThe same bone surgery for a smaller area.per quadrant · Done sometimesD4263MajorBone graft for gum disease, first siteBone material is placed where gum disease destroyed bone, first site in a quarter.per site · Done sometimesD4264MajorBone graft for gum disease, each extra siteEach additional graft site in the same quarter of the mouth.per site · Done sometimesD4265MajorHealing protein added to gum surgeryA biologic gel added during surgery to encourage bone and gum to regrow.per site · Rarely doneD4266MajorHealing membrane, dissolving typeA barrier placed over a graft that dissolves on its own.per site · Done sometimesD4267MajorHealing membrane, non-dissolving typeA barrier that has to be removed at a later visit.per site · Rarely doneD4268MajorTouch-up gum surgeryA small revision of an earlier gum surgery.per tooth · Rarely doneD4274MajorRemoving a wedge of gum behind a toothA small wedge of thick gum is removed behind the last tooth to reduce a pocket.per tooth · Rarely doneD4920BasicEmergency dressing changeA different dentist replaces the surgical dressing after gum surgery.per visit · Rarely doneD4999MajorOther gum procedureThe catch-all code for a gum procedure that has no code of its own.per visit · Rarely done

Related

Have this on your plan?

Upload it or type the lines. We read it and show what happened to other patients. Free, no account.

Check the estimate I gotFind a dentist who does this
No dental office can pay to change what we show you.
Healing membrane, dissolving type (D4266): what happens, step by step | TruthMolar