D3425 is the CDT code for an apicoectomy on a molar, first root. An apicoectomy is the surgical removal of the root tip and the infected tissue around it, usually after conventional root canal therapy has not resolved the problem. Because molars have multiple roots, D3425 reports the first root, and each additional root surgically treated is reported with D3426.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D3425 claims →Use D3425 when performing an apicoectomy on a molar. The procedure surgically removes the root tip and the surrounding periapical pathology, typically when conventional root canal therapy or retreatment has not resolved persistent infection. D3425 reports the first root, and additional roots treated on the same molar are reported with D3426.
Common clinical scenarios: A molar with persistent periapical pathology after root canal therapy. A molar where retreatment is not feasible and surgery is indicated. A molar with a periapical lesion on one or more roots requiring surgical access to the root ends.
Do NOT use D3425 for: An anterior tooth (use D3410). A premolar (use D3421). Each additional root beyond the first on the same molar (use D3426). A retrograde filling, which is reported separately with D3430.
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The base apicoectomy code for a molar. Reports the first root surgically treated on the tooth. This code is used once per molar.
Reported for each additional root treated on the same tooth beyond the first. A molar with surgery on two or three roots adds D3426 units for the extra roots.
Billing tip: Report D3425 once for the first root, then D3426 for each additional root surgically treated on that molar. Do not report multiple first-root codes on the same tooth. The number of roots treated should match the documentation.
D3425 is the molar code. Using it on a premolar or anterior tooth is a position mismatch. Premolar is D3421 and anterior is D3410. When the tooth number does not match the code, payers flag the inconsistency and deny the claim. Confirm the tooth type before selecting the code.
Molars have multiple roots, so additional roots use D3426, not a second D3425. Reporting two first-root codes on the same tooth is an error. The number of D3426 units should match the additional roots treated. Misreporting the roots leads to denials or reductions.
Endodontic surgery requires imaging that shows the periapical pathology. Without a radiograph demonstrating the lesion and the root ends, the payer cannot see why surgery was needed. Include preoperative imaging that supports the diagnosis and the surgical approach.
Surgical claims need an operative note describing the procedure. The note should describe the flap, the root end resection on each root, and the management of the periapical tissue. Thin documentation that does not describe the surgery can lead to denials.
Record the specific molar treated. The tooth number must correspond to a molar so the code and position are consistent.
Document how many roots were surgically treated. The first root is D3425 and each additional root is reported with D3426.
Include imaging that shows the periapical pathology and the root ends. This is the primary justification for the surgery.
Document the prior root canal therapy and the persistent pathology that made the apicoectomy necessary.
Describe the surgical procedure, including flap reflection, root end resection on each root, and any retrograde filling reported separately with D3430.
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Learn about our billing servicesD3425 is the CDT code for an apicoectomy on a molar, first root. An apicoectomy is the surgical removal of the root tip and surrounding infected tissue. D3425 reports the first root treated on a molar, with additional roots reported using D3426.
D3425 is the apicoectomy of the first root on a molar. D3426 is reported for each additional root treated on the same tooth. Because molars have multiple roots, a single molar apicoectomy often involves D3425 plus one or more units of D3426.
D3425 is an apicoectomy on a molar, while D3421 is an apicoectomy on a premolar. The codes are separated by tooth type. A molar uses D3425, a premolar uses D3421, and an anterior tooth uses D3410.
The first root is reported with D3425 and each additional root surgically treated on the same molar is reported with D3426. A molar with surgery on multiple roots will have one D3425 and additional D3426 units matching the extra roots treated.
Not necessarily. A retrograde filling placed at a resected root end is reported separately with D3430, retrograde filling, per root. Confirm whether a retrograde filling was placed and report it in addition when appropriate.
Common reasons include a tooth type mismatch, such as using the molar code on a premolar, missing radiographs showing the periapical pathology, no prior endodontic history, incorrect reporting of additional roots, and incomplete operative notes.
Search all 206 CDT codes in our dental coding guide.