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When removing multiple teeth in the same area, the remaining bone often requires smoothing and contouring for proper healing. Dental code D7311 covers alveoloplasty performed at the same time as tooth extractions in one quadrant. This article explains when D7311 applies, how it differs from standalone alveoloplasty, and what documentation supports your billing.
Nov 1, 2025
What is Dental Code D7311?
D7311 describes alveoloplasty performed in conjunction with extractions when treating four or more teeth per quadrant. The procedure involves reshaping and smoothing the alveolar ridge after removing teeth to eliminate sharp edges, irregular bone, and create favorable contours for healing. You use this code when bone recontouring is necessary at the time of extraction to prepare the site for prosthetic devices or to promote optimal tissue healing.
D7311 is billed per quadrant and must be performed during the same surgical appointment as the extractions. The code requires at least four extractions in the quadrant to qualify for this specific alveoloplasty code.
Common Terminology
Understanding surgical terminology helps you document extraction and bone contouring procedures accurately and select appropriate codes.
Alveoloplasty: Surgical reshaping and smoothing of the alveolar bone following tooth removal
Alveolar ridge: The bone that previously surrounded and supported teeth before extraction
Bone recontouring: Removal of sharp edges, undercuts, and irregular bone projections after extractions
Primary closure: Suturing tissue over the surgical site to cover exposed bone and promote healing
When is D7311 Used?
Alveoloplasty becomes necessary when removing multiple teeth creates irregular bone contours that would interfere with denture fit or healing. Smoothing the ridge at the time of extraction reduces the need for future surgical procedures.
Your treatment planning should consider whether the patient needs immediate denture placement or if significant bone irregularities will remain after extractions.
Common Clinical Scenarios
You'll find several situations where performing alveoloplasty during extractions improves outcomes and prepares sites for prosthetics.
Full denture preparation: When removing all remaining teeth in a quadrant or arch to prepare for complete dentures
Immediate denture placement: When delivering dentures on the same day as extractions and requiring smooth bone contours for proper fit
Multiple adjacent extractions: When removing four or more teeth in one quadrant creates sharp interdental bone or irregular ridge height
Severe bone irregularities: When extraction sites have significant bone projections, tori, or exostoses requiring removal for proper healing
Partial denture preparation: When extracting multiple teeth and recontouring bone to accommodate removable partial denture framework
When D7311 is NOT Appropriate
Knowing when different alveoloplasty codes apply prevents billing errors and ensures accurate procedure documentation.
Fewer than four extractions: When removing 1-3 teeth per quadrant, use D7310 for alveoloplasty with limited extractions instead
Standalone alveoloplasty: When performing bone recontouring without extractions at the same appointment, use D7320 for alveoloplasty not in conjunction with extractions
Single extraction site: When smoothing bone around one extraction site as routine socket care, alveoloplasty is included in the extraction code
Minor socket trimming: When making small adjustments to socket edges as part of standard extraction technique rather than quadrant-wide recontouring
Future bone grafting planned: When preserving bone for implant placement rather than smoothing for denture preparation, document differently
Billing and Insurance Considerations
Documentation distinguishes necessary surgical bone recontouring from routine extraction technique that's already included in extraction codes. Insurance companies review whether alveoloplasty was truly required for the clinical situation.
Your records should describe the extent of bone irregularities, the recontouring performed, and the clinical reason for the procedure.
Documentation Requirements
Your clinical records must demonstrate that significant bone recontouring was performed beyond what's normally included in extraction procedures. Detailed surgical notes support medical necessity.
Number of extractions: Document that four or more teeth were extracted in the quadrant where alveoloplasty was performed
Bone irregularities: Describe specific bone projections, sharp edges, undercuts, or ridge irregularities requiring surgical correction
Extent of recontouring: Note which areas of the alveolar ridge required smoothing and approximately how much bone was removed
Surgical technique: Record whether you used rongeurs, bone files, or surgical burs to reshape the ridge and whether primary closure was achieved
Prosthetic indication: Explain whether alveoloplasty was performed for immediate denture placement, future prosthetic needs, or optimal healing
Insurance Coverage
Coverage for D7311 varies based on whether plans consider the alveoloplasty medically necessary or include it as part of the extraction procedure. Most plans provide some reimbursement when documentation supports separate surgical recontouring.
Medical necessity requirement: Plans require documentation showing that significant bone work was necessary beyond routine extraction socket care
Typical coverage percentage: Plans covering oral surgery usually reimburse D7311 at 50-80% under major services after deductible
Bundling considerations: Some carriers bundle alveoloplasty into extraction codes and won't pay separately without strong documentation
Pre-authorization needs: Plans may require pre-authorization when billing both multiple extractions and D7311 in the same quadrant
Prosthetic coordination: Coverage often improves when alveoloplasty is performed in preparation for dentures being fabricated and billed
Common Billing Mistakes
Errors in coding D7311 typically involve confusion about when bone recontouring qualifies as separately billable versus included in extractions.
Insufficient extractions: Billing D7311 when fewer than four teeth were extracted, which should be D7310 instead
Routine socket care: Charging D7311 for minor socket trimming that's included in the extraction code rather than extensive ridge recontouring
Missing documentation: Submitting claims without surgical notes describing the extent and necessity of bone work performed
Wrong date of service: Billing D7311 separately from extraction codes or on different dates when they must be same-day procedures
Multiple quadrant confusion: Billing one unit of D7311 for work spanning multiple quadrants instead of billing per quadrant
Common Questions About D7311
What's the difference between D7310 and D7311?
The primary difference is the number of extractions performed in the quadrant. D7310 covers alveoloplasty performed with 1-3 extractions per quadrant, while D7311 applies when you extract four or more teeth per quadrant. Both codes describe bone recontouring done at the same appointment as extractions. Count the teeth extracted in each quadrant carefully and use the appropriate code. If you extract three teeth in one quadrant and five in another, you would bill D7310 for the first quadrant and D7311 for the second.
Can I bill D7311 if I'm not placing an immediate denture?
Yes, D7311 isn't limited to cases involving immediate denture placement. You can bill alveoloplasty whenever significant bone recontouring is necessary after multiple extractions, even if the patient will heal for several months before prosthetic treatment. However, your documentation should explain why extensive ridge reshaping was clinically necessary. Common justifications include removing sharp bone edges, eliminating severe undercuts, creating symmetric ridge contours, or preparing for future prosthetic fabrication.
Is alveoloplasty included in the extraction codes?
Minor socket trimming and smoothing of sharp edges around individual extraction sites are included in extraction codes and shouldn't be billed separately. However, D7311 describes extensive surgical recontouring of the entire alveolar ridge across multiple extraction sites in a quadrant. If you're using rongeurs or surgical burs to remove significant amounts of bone, reshape ridge height, or eliminate large irregularities beyond normal extraction technique, then D7311 is appropriate. Document the extent of bone work to distinguish it from routine extraction socket care.
How many units of D7311 can I bill per appointment?
You can bill up to four units of D7311 per appointment if you perform alveoloplasty in all four quadrants during the same visit. Bill one unit per quadrant where you extract four or more teeth and perform significant bone recontouring. If you extract teeth in multiple quadrants but only perform extensive alveoloplasty in one or two quadrants, bill D7311 only for the quadrants where recontouring occurred. Don't automatically bill D7311 for every quadrant with extractions unless bone work was actually necessary in each area.
Can I bill both D7311 and bone grafting codes on the same site?
Generally, you would not bill both D7311 and bone grafting codes for the same extraction sites. D7311 describes removing and smoothing bone to create favorable ridge contours, while bone grafting involves adding material to preserve or augment the ridge. These are opposite goals. If you're grafting sockets for implant site preservation, you typically wouldn't also perform alveoloplasty that removes bone from those sites. However, you might perform alveoloplasty in one area of a quadrant while grafting specific sockets in another area, which would require clear documentation of the different sites and procedures.
Keep Your Surgical Schedule Moving With Dependable Staff
Multiple extractions and alveoloplasty procedures require skilled assistants who understand surgical protocols and can anticipate your needs. When team members are unavailable and surgical appointments get postponed, patients face extended periods with damaged teeth and delayed prosthetic treatment. Teero provides access to experienced dental hygienists who can cover gaps that arise during surgical treatment and planning. Sign up with Teero and ensure your practice has the staffing support to deliver timely care.