Negotiated reimbursement rates for D4212 across 47 states, sourced from CMS Transparency in Coverage data. 426 rate records.
D4212 refers to a gingivectomy or gingivoplasty procedure performed on a per tooth basis. This surgical procedure involves the removal or reshaping of gum tissue to improve aesthetics or facilitate restorative work. Clinical indications for this procedure include the presence of excessive gingival tissue, periodontal disease, or the need for crown lengthening. Proper documentation is essential, including pre-operative and post-operative photographs, periodontal charting, and a detailed treatment plan. Billing notes should reflect the specific tooth treated and any related procedures. Reimbursement for D4212 can vary significantly by payor and state, with average payments around $156. Some insurance plans may have limitations on coverage based on medical necessity or frequency of treatment, so verifying benefits prior to treatment is advisable.
Reimbursement rates for D4212 vary significantly by state, payor, and provider network. The national average negotiated rate is $156. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
44+ more states available with Pro ↓