Surgical dental extraction is the removal of a tooth from its socket and frequently involves incisions, elevation of mucoperiosteal flaps, removal of bone, sectioning of tooth structure, and use of specialized instruments to access and extract the tooth. The procedure is indicated when a tooth cannot be retained or restored due to clinical conditions such as pain, dental caries, periodontal disease, periapical pathology, infection, split or cracked tooth, tooth mobility, internal/external root resorption, severe crown/root anomalies that preclude restorative treatment, traumatic injury, loss of pulp vitality secondary to infection, ectopic position causing damage to other teeth, or when prophylactic removal is medically necessary (for example, prior to organ transplant, chemotherapy, radiation therapy, prosthetic heart valve or joint replacement, or for certain orthodontic indications).
Tooth position and how much of the tooth is covered determine the surgical technique and appropriate CDT procedure code. An erupted tooth or exposed root may be removed with elevation and/or forceps (e.g., D7140), while an erupted tooth that requires bone removal or sectioning and flap elevation is coded as a surgical removal (e.g., D7210). Impacted teeth are defined as those that cannot fully erupt because of abnormal position or impingement; impacted removal codes depend on coverage by soft tissue or bone: D7220 for soft-tissue-covered, D7230 for partially bony, and D7240 for completely bony impactions. Complex completely bony removals with documented unusual surgical complications may be billed as D7241 when clinical notes support those complications.
Other procedure codes address specific situations: D7111 for coronal remnants of primary teeth, D7250 for removal of residual roots, D7251 for coronectomy (intentional partial tooth removal of impacted teeth when full removal risks neurovascular injury), and D7252 for partial extraction techniques used with immediate implant placement. Accurate coding requires correlating the anatomic position, degree of impaction, and operative maneuvers performed with the CDT code selected.