D6104 is the CDT code for a bone graft placed at the time of implant placement, reported per implant. The graft material augments the bone around an implant fixture during the same surgical visit the implant is set, for example to fill a gap, a dehiscence, or a fenestration around the fixture. It is different from a standalone ridge graft and from a graft that repairs an existing implant defect.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Use D6104 when graft material is placed around an implant during the same appointment the implant is placed. The graft augments the bone at the fixture, for example to fill a gap between the implant and the socket wall, or to cover a dehiscence or fenestration exposed during placement. The code is reported per implant, so each fixture that receives a graft is documented on its own.
Common clinical scenarios: An implant placed into a recent extraction site where a gap remains between the fixture and the bony walls. A buccal dehiscence or fenestration found when the implant is seated. A site where the surgeon adds graft material to support bone volume around the fixture at the time of placement.
Do NOT use D6104 for: A standalone ridge augmentation graft done before an implant is placed (use D7950, or D6101, D6102, or D6103 depending on context). A bone graft that repairs a defect around an implant that was placed earlier (use D6103). Sinus augmentation (use D7951 or D7952). Guided tissue regeneration around a natural tooth (use D4263 or D4266). A graft at a non-implant site.
Click any code to see the difference.
Graft material placed around an implant at the same visit the fixture is set. It adds bone volume, it does not clean an existing defect.
Debridement of a peri-implant defect plus surface cleaning of the implant. The work is cleaning and treating an existing problem, not grafting at placement.
Billing tip: D6104 adds bone at the moment the implant goes in. D6101 cleans and debrides a defect around an implant that already exists. Describe the surgical intent in the note so the payer can tell which one you performed.
Some payers treat the graft as included in the implant placement fee. When that happens the graft line is denied as bundled even though the work was distinct. A clear operative note showing the graft was a separate step, with the defect that required it, supports reporting it on its own line.
D6104 is reported per implant, so each fixture that received a graft needs its own support. If grafts were placed around more than one implant and the record does not tie each graft to a specific site, units can be denied or cut. Document the site and the graft for every fixture.
Payers want to see why a graft was needed. A note describing the gap, dehiscence, or fenestration that was grafted answers the question before it is asked. Without a narrative tying the graft to a real defect at placement, the claim is easy to deny.
Bone graft work can fall under a medical benefit or a limited dental benefit depending on the plan. Sending the claim to the wrong carrier, or missing the documentation that carrier expects, leads to a denial. Verify benefits and routing before the surgery, and match the product and material documentation to what that payer requires.
Describe the gap, dehiscence, or fenestration found at placement and why graft material was added around the fixture. The operative note is the primary support for the graft.
Record the site for each implant that received a graft. Because D6104 is reported per implant, each fixture and its graft need to be documented separately.
Document the graft material used, including product and quantity where the payer asks for it. Missing material documentation is a common reason graft lines are held or denied.
Confirm the implant was placed at the same visit as the graft. The same-day timing is what makes D6104 the correct code rather than D6103 or D7950.
Check whether the graft falls under a medical or a dental benefit for this plan, and route the claim accordingly. Record any pre-authorization number and include it on the claim.
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Learn about our billing servicesD6104 is the CDT code for a bone graft placed at the time of implant placement, reported per implant. It covers graft material used to augment the bone around an implant fixture being placed at the same surgical visit, such as filling a gap, a dehiscence, or a fenestration around the implant.
D6104 is a bone graft placed at the same time the implant is inserted. D6103 is a bone graft for the repair of an implant defect that is done as a separate procedure, not at the original placement. The timing relative to implant placement is what separates the two codes.
D6104 is a graft placed around an implant during the same visit the implant is set. D7950 is a standalone osseous or ridge augmentation graft done on its own, often before any implant is placed. D6104 always accompanies an implant placement, D7950 does not.
Common reasons: bundling where the payer treats the graft as part of the implant fee, missing per-implant documentation, no operative note describing the defect grafted, medical versus dental routing problems, and missing graft material or product documentation.
Yes. D6104 is reported per implant. When grafts are placed around more than one implant in the same visit, document the site and graft for each fixture so each reported unit is supported on its own.
No. D6104 is only for a bone graft placed around an implant at the time the implant is set. Sinus augmentation uses D7951 or D7952, and guided tissue regeneration around a natural tooth uses D4263 or D4266. Pick the code that matches the site and the procedure.
Search all 206 CDT codes in our dental coding guide.