D6104 is the CDT code for a bone graft performed at the same appointment as implant placement — augmenting bone around a newly placed implant to support osseointegration. It's reported only when the graft and the implant placement happen together.
Informational only — confirm the official CDT descriptor and your payers' rules independently. This is general guidance, not billing, coding, or clinical advice.
When to Use the D6104 Code
Report D6104 when bone augmentation is done concurrently with implant placement — for example, to fill a gap, correct a small defect, or improve bone support around the fixture at the time it is placed. The defining factor is timing: the graft is performed at the same surgical appointment as the implant.
Pick the code by when and where the graft is done. D6104 is a graft at the time of implant placement. A graft at an extraction site for ridge preservation is D7953, and a staged or standalone ridge augmentation done before implant placement uses a different code. The implant body itself is reported separately with D6010. Coding by the actual timing and purpose matters, because grafts done at different stages are reimbursed under different rules.
Documentation & Clinical Scenarios
Grafts are scrutinized benefits, so documentation should justify the augmentation:
- Site number and confirmation the graft was placed at the time of implant placement.
- A narrative describing the defect or need for augmentation and the graft material used.
- Radiograph(s) showing the site before and, where available, after placement.
- Operative notes tying the graft to the same surgical appointment as the implant.
The implant placement (D6010) is billed separately, as is any membrane or biologic if applicable per payer rules. Keep the imaging and narrative in the chart, since grafts are frequently reviewed and may require justification on appeal.
Insurance & Billing Tips
- Verify graft and implant benefits separately. Some plans cover implants but exclude grafts, or vice versa.
- Document concurrency. The claim should make clear the graft was placed at the same visit as the implant, which is what distinguishes D6104 from staged grafts.
- Attach a narrative and radiographs. These support medical necessity and reduce review delays.
- Bill the implant separately. D6104 is the graft only; the implant body is D6010.
- Don't confuse it with ridge preservation. A graft at an extraction site is D7953, not D6104.
Example Case
A 49-year-old patient has an implant placed at a site with a small buccal bone deficiency. To support the fixture, the surgeon places a bone graft at the same appointment. The office documents the defect with a radiograph and operative note, writes a narrative describing the augmentation and the material used, and files D6010 for the implant body and D6104 for the graft placed at the time of placement. Because the documentation clearly established that the graft was concurrent with implant placement — not a separate ridge-preservation procedure — both claims are processed at the expected level.
Patients call about "the implant surgery" or "building up the bone," not D6104. DentalReception AI answers and books those calls 24/7, captures insurance details, and routes clinical and billing questions to your team. See how it handles implant consultation calls, or book a demo.
Frequently Asked Questions
What's the difference between D6104 and D7953?
Timing and purpose. D6104 is a bone graft placed at the time of implant placement, augmenting bone around a freshly placed fixture. D7953 is a bone graft for ridge preservation at an extraction site, typically done to maintain the ridge for a future implant or restoration. They occur at different stages of care, so code by what actually happened — using D6104 for a graft concurrent with implant placement and D7953 for socket preservation.
Does D6104 include the implant itself?
No. D6104 covers only the bone graft. The surgical placement of the implant body is reported separately with D6010, and any abutment or crown later is its own code. An implant case with grafting therefore appears on the claim as multiple line items — the implant, the graft, and the eventual restorative components — each with its own documentation.
Will insurance cover a D6104 bone graft?
It varies. Some plans cover grafts performed with implant placement; others exclude bone grafts or implant-related services entirely. Coverage may also depend on documented medical necessity. Verify graft and implant benefits separately before treatment, and submit a narrative with radiographs showing the defect, so the patient's estimate is accurate and the claim has the support it needs.
Do I need a pre-authorization or narrative for D6104?
A narrative is strongly recommended, and many plans suggest a pre-estimate for graft and implant procedures. Document the defect, the graft material, and that the graft was placed at the same appointment as the implant, and attach radiographs. Because grafts are frequently reviewed, clear documentation of concurrency and necessity up front reduces the risk of denial and helps set accurate patient expectations.
Confirm the current CDT descriptor and your specific payer policies before billing — browse the full dental code library or see our insurance verification feature.