D7460 is the CDT code for the surgical removal of a benign nonodontogenic cyst or tumor — a non-malignant growth that does NOT arise from tooth-forming tissues — when the lesion measures up to 1.25 cm in diameter. It applies to cysts and benign soft-tissue or bony lesions of the oral cavity that are unrelated to tooth development.
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 D7460 Code
Report D7460 when a dentist or oral surgeon removes a benign, nonodontogenic cyst or tumor — a lesion that does not originate from tooth-forming tissue — and the lesion is 1.25 cm or smaller in diameter. Examples include certain soft-tissue cysts, benign mucosal or salivary-related growths, and other benign lesions of the jaws and oral cavity unrelated to teeth.
Match the code to origin and size. If the same nonodontogenic lesion exceeds 1.25 cm, the correct code is D7461. If the lesion is odontogenic (derived from tooth tissue), use D7450 (up to 1.25 cm) or D7451 (larger). The pathology report determines origin, so do not finalize between D7460 and D7450 until it is back.
Documentation & Clinical Scenarios
Because the origin and size drive the code, the chart needs to support both:
- Site and a clear clinical diagnosis identifying the lesion as nonodontogenic.
- Lesion diameter in centimeters to confirm the up-to-1.25 cm threshold.
- Radiograph(s) or imaging when a bony lesion is involved, and clinical photos for soft-tissue lesions.
- A pathology/biopsy report confirming the benign, nonodontogenic nature; payers typically require it before payment.
- A narrative describing the surgical approach and any factors that complicated removal.
Procedures performed separately — a distinct biopsy, grafting, or closure of a large defect — are documented and billed under their own codes rather than bundled into D7460.
Insurance & Billing Tips
- Verify benefits and routing. Removal of a nonodontogenic lesion may fall under medical rather than dental benefits; confirm where to file before treatment.
- Attach the pathology report. Most carriers will not pay without histopathologic confirmation that the lesion is benign and nonodontogenic.
- Match the size to the code. A lesion over 1.25 cm is D7461, not D7460; size mismatches are a frequent denial reason.
- Keep odontogenic vs. nonodontogenic straight. Reporting D7460 for an odontogenic lesion (which should be D7450) commonly leads to a denial once the pathology is reviewed.
- Support appeals with records. Imaging, photos, and the pathology report together make a strong case if the claim is initially denied.
Example Case
A 39-year-old patient is referred for a firm nodule on the inner cheek that has been present for months. The oral surgeon measures it at about 0.8 cm and excises it under local anesthesia, sending the specimen to pathology. The report identifies a benign nonodontogenic soft-tissue lesion, and the removal is reported as D7460. Because the diameter and the nonodontogenic diagnosis were documented and the pathology report was attached, the claim is paid without a request for additional information.
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Frequently Asked Questions
How is D7460 different from D7450?
The difference is the lesion's origin. D7460 is for nonodontogenic cysts and tumors — growths that do not come from tooth-forming tissue. D7450 is for odontogenic lesions that arise from those tissues, such as dentigerous cysts. Both base codes cover lesions up to 1.25 cm, and the pathology report is what determines which one applies, so confirm origin before finalizing the code.
Does D7460 include the pathology and any separate closure?
No. D7460 covers the surgical removal itself. The pathology/biopsy report is reported separately by the lab, and any separate graft or complex closure of a resulting defect is billed under its own CDT code. Bundling these onto the D7460 line is a common cause of denials, so report each component on its own.
Will insurance cover removal of a benign nonodontogenic cyst?
Coverage varies, and these lesions frequently fall under medical rather than dental benefits. Carriers generally require a pathology report confirming the benign, nonodontogenic diagnosis, along with imaging or photos. Verify benefits and confirm whether the claim should go to the medical or dental plan before treatment to avoid an unexpected balance.
Does D7460 require pre-authorization?
Pre-authorization is not always mandatory, but a pre-treatment estimate with supporting imaging or photos is recommended because payers review these surgical claims closely. Submitting the diagnosis and planned approach up front confirms remaining benefits, clarifies medical-versus-dental routing, and reduces the chance of a denial or a large patient balance.
Confirm the current CDT descriptor and your specific payer policies before billing — browse the full dental code library or see our insurance verification feature.