D4211Gingivectomy or Gingivoplasty - One to Three Contiguous Teeth or Tooth Bounded Spaces Per Quadrant

What This Code Covers

D4211 covers the surgical removal (gingivectomy) or reshaping (gingivoplasty) of gum tissue involving one to three contiguous teeth or tooth-bounded spaces in a single quadrant. This is a more localized version of D4210, used when gum disease or tissue overgrowth affects a smaller area. The procedure removes excess or diseased gum tissue to reduce pockets or restore normal gingival contour.

Billing Guide

Bill this code when:

• Gingivectomy or gingivoplasty is performed on one to three contiguous teeth in one quadrant
• The procedure addresses localized gum disease, tissue overgrowth, or abnormal gingival contour
• Tissue is surgically removed or reshaped for periodontal health
• The indication is periodontal, not cosmetic or restorative crown lengthening

Do not bill this code when:

• Four or more contiguous teeth are treated in the quadrant. Use D4210
• Osseous (bone) surgery is also performed. Use D4260 or D4261
• The procedure is crown lengthening for a restoration. Use D4249
• The tissue removal is incidental to another procedure (e.g., operculectomy)

Insurance and Denial Prevention

Key Payer Rules:

• D4211 is a per-quadrant code limited to one to three contiguous teeth
• Most payers require documentation of the periodontal condition being treated
• Some plans may have a benefit maximum or frequency limit for gingivectomy procedures
• If multiple quadrants are treated on the same date, bill D4211 per quadrant as applicable

Common Denials and How to Respond:

• Not medically necessary - Submit periodontal charting and clinical notes documenting pseudopockets, tissue overgrowth, or persistent pockets after initial therapy.
• Cosmetic procedure - Clarify the medical indication (periodontal disease, drug-induced hyperplasia, tissue impinging on restoration margin).
• Should be D4210 - Verify the tooth count. D4211 is correct for one to three contiguous teeth; D4210 is for four or more.