D7450 is the CDT code for the surgical removal of a benign odontogenic cyst or tumor — a non-malignant growth that arises from tooth-forming tissues — when the lesion measures up to 1.25 cm in diameter. It covers enucleation or excision of lesions such as dentigerous cysts, odontogenic keratocysts, or small contained odontogenic tumors confined to that size.
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 D7450 Code
Report D7450 when a dentist or oral surgeon removes a benign, odontogenic cyst or tumor — one that develops from the tissues that form teeth — and the lesion is 1.25 cm or smaller in diameter. Common examples include dentigerous cysts around an unerupted tooth, odontogenic keratocysts, and small ameloblastomas.
Match the code to origin and size. If the same type of lesion exceeds 1.25 cm, the correct code is D7451. If the lesion is nonodontogenic (not derived from tooth tissue), use D7460 (up to 1.25 cm) or D7461 (larger). Do not confuse D7450 with a routine extraction or with malignant tumor codes; the diagnosis must support a benign odontogenic lesion.
Documentation & Clinical Scenarios
Surgical-pathology claims are reviewed closely, so the chart should leave no doubt about what was removed:
- Tooth number or site and a clear clinical diagnosis (e.g., dentigerous cyst, odontogenic keratocyst).
- Lesion diameter documented in centimeters to support the size threshold (up to 1.25 cm).
- Radiograph(s) — periapical, panoramic, or CBCT — showing the lesion's extent.
- A pathology/biopsy report confirming the benign, odontogenic nature; most payers require it before they will pay.
- A narrative describing the surgical approach (enucleation, curettage) and any complicating factors.
Anything done separately — extraction of an associated tooth, bone grafting, or a separate biopsy — is documented and billed under its own code rather than bundled into D7450.
Insurance & Billing Tips
- Verify benefits and the medical-vs-dental split. Cyst and tumor removal sometimes routes to medical coverage; confirm where the claim should go before treatment.
- Attach the pathology report. Most carriers will not pay a cyst/tumor removal without histopathologic confirmation, and many treat it as a denial until the report arrives.
- Match the size to the code. A lesion over 1.25 cm should be D7451, not D7450; an incorrect size code is a common cause of down-coding or denial.
- Bill associated procedures separately. Extractions, grafts, and biopsies are reported on their own lines with their own codes.
- Document medical necessity for appeals. A clear narrative plus imaging and pathology supports a strong appeal if the claim is initially denied.
Example Case
A 27-year-old patient presents with a painless swelling near an impacted lower wisdom tooth. A panoramic radiograph shows a well-defined radiolucency, and the oral surgeon measures the lesion at roughly 1 cm. The cyst is enucleated, the specimen is sent to pathology, and the report confirms a dentigerous cyst. The removal is reported as D7450, with the wisdom-tooth extraction billed under its own surgical-extraction code. Because the office attached the radiograph and pathology report, the claim processes without a request for additional records.
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Frequently Asked Questions
How is D7450 different from D7460?
Both cover removal of a benign cyst or tumor up to 1.25 cm, but the origin differs. D7450 is for odontogenic lesions — those that arise from tooth-forming tissues, such as dentigerous cysts and odontogenic keratocysts. D7460 is for nonodontogenic lesions that do not come from tooth tissue. The pathology report drives which code is correct, so coding before the report is a frequent source of errors.
Does D7450 include the pathology lab work and any associated extraction?
No. D7450 covers the surgical removal itself. The pathology/biopsy report is generated by the lab and reported separately, and an associated tooth extraction or bone graft is billed under its own CDT code. Bundling these onto the D7450 line commonly triggers denials, so report each component distinctly.
Will insurance cover removal of a benign odontogenic cyst?
Many plans cover it when medical necessity is documented, but coverage varies and the lesion may fall under medical rather than dental benefits. Carriers almost always require a pathology report confirming the benign odontogenic diagnosis, plus supporting radiographs. Verify benefits and the medical-versus-dental routing before treatment to avoid surprises.
Does D7450 require pre-authorization?
Pre-authorization isn't universally required, but a pre-treatment estimate with the diagnostic imaging is strongly recommended for cyst and tumor removal because payers review these surgical claims closely. Submitting imaging and the planned approach up front confirms remaining benefits and reduces the chance of a denial or a large patient balance after the fact.
Confirm the current CDT descriptor and your specific payer policies before billing — browse the full dental code library or see our insurance verification feature.