Crown Lengthening Cost Per Tooth: 2026 US Ranges

“Crown lengthening cost per tooth” is a reasonable way to shop, but the procedure is not priced like a filling. The fee is built around a surgical site: the surgeon opens the gum, decides how much bone to remove, positions the tissue and follows the healing. The number of teeth in that site changes the fee less than the number of sites does.

The short answer

These are cash-pay planning ranges for the surgical fee. They exclude the consultation, imaging, sedation, a temporary crown and the final restoration. They are not quotes, and they are not a city-by-city price index.

Why the first tooth carries most of the fee

Every periodontal surgical fee has a fixed component: the consultation and planning, anaesthesia, setting up a sterile field, the surgeon’s time, sutures, post-operative instructions and a review visit. That component does not shrink because the case is small.

When a second adjacent tooth is added, most of that setup is already paid for. The extra work is the additional root surface, a wider flap and more suturing. Practices commonly price the second tooth at 40% to 60% of the first, and a third at a similar increment. That is why a two-tooth quote of $1,800 can be better value per tooth than a one-tooth quote of $1,200 — and why comparing a per-tooth quote with a quadrant quote without converting them is misleading.

Tooth position matters

Anterior teeth are easier to access, have a single root and usually need less bone removal. The surgical fee tends to sit at the lower end. The exception is aesthetic work: if the gum line has to be matched across four to six front teeth, the planning and the visible result justify a higher fee.

Premolars sit in the middle. Access is good, the root surface is larger than an incisor’s, and the bone is thicker.

Molars are the most expensive single-tooth sites. Three roots, thicker bone, a furcation that must be protected and limited access all add time. A molar crown lengthening at the top of the range is not unusual.

Gum only or gum and bone?

This is the single biggest fork in the quote. A gingivectomy removes a strip of gum and stops there. It is appropriate when the bone level is already correct and the tooth looks short only because excess gum covers it. The procedure is quicker, often needs no sutures and costs roughly half as much.

Crown lengthening with bone recontouring is a flap procedure. The gum is raised, bone is reduced around the root, the flap is repositioned and sutured. It is the operation required when a crown margin would otherwise sit within about 2 mm of the bone, or when the teeth are short because the bone itself sits high.

If one quote is $450 and another is $1,600 for the same tooth, the difference is usually not markup. It is two different operations. Ask which procedure each quote describes before comparing the totals.

What a written quote should show

A useful estimate names the tooth or teeth, the procedure in plain language, the CDT code and the fee for each line. For crown lengthening the common codes are:

• D4249 — clinical crown lengthening, hard tissue
• D4210 / D4211 — gingivectomy or gingivoplasty, by quadrant size
• D4260 / D4261 — osseous surgery, by quadrant size

The quote should also say whether the consultation, imaging, sedation and suture removal are included, and whether a temporary crown is part of the plan. If the answer is “it depends”, ask what it depends on and get the range in writing.

The costs that sit outside the surgical fee

• Consultation and imaging: $100–$300; sometimes credited toward surgery.
• Sedation: $150–$800, depending on oral versus IV and who provides it.
• Temporary crown: $100–$400 if the tooth is prepared before the gum heals.
• Final crown: commonly $1,000–$2,000 or more, billed by the restoring dentist.
• Bone graft or membrane: $400–$1,200 when a combined site needs rebuilding.
• Extra follow-up visits: $50–$150 each at some practices.

A patient comparing two quotes should compare the total plan, not the surgical line. A practice that charges $900 for surgery but requires a separate $350 consultation and a $300 temporary may be more expensive than one that quotes $1,400 all-in.

Does insurance change the per-tooth number?

It can, but not predictably. When crown lengthening is documented as necessary for a restoration or for periodontal health, a plan may pay 50% to 80% of its allowed fee after a deductible, up to an annual maximum. Aesthetic contouring is usually excluded entirely. The annual maximum — often $1,000 to $2,000 — can be used up by the surgery alone.

The practical move is a pre-treatment estimate: give the office your plan details and ask them to submit the proposed code before the appointment. The written response is the only reliable answer. The insurance guide walks through the questions.

How to compare local quotes

Pick two or three periodontal practices in your city, give each the same information — tooth number, the dentist’s reason for the referral and any imaging — and ask for the same four lines: procedure, CDT code, total surgical fee and what is excluded. Then compare.

The periodontist directory lists practices by state and city with phone numbers and websites. Listings are a starting point, not an endorsement, and the office has to confirm the procedure and the fee.