Gingival Flap Surgery — 4+ Teeth (Per Quad) (D4240) — National Rates

Negotiated reimbursement rates for D4240 across 49 states, sourced from CMS Transparency in Coverage data. 641 rate records.

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National Average Negotiated Rate
$480
641 rate records · 49 states
📊 Data updated monthly · Last refresh: March 2026

About D4240 — Gingival Flap Surgery — 4+ Teeth (Per Quad)

D4240 refers to gingival flap surgery for four or more teeth, billed on a per quadrant basis. This surgical procedure involves lifting the gum tissue to gain access to the underlying bone and teeth for treatment of periodontal disease. Clinical indications include severe periodontal disease, bone loss, or the need for surgical intervention to restore periodontal health. Proper documentation should include periodontal assessments, treatment plans, and post-operative care instructions. Average reimbursement for D4240 is approximately $480, but this can vary significantly based on the patient's insurance plan and state regulations. Some payors may require pre-authorization or specific documentation to support the necessity of the procedure.

Reimbursement rates for D4240 vary significantly by state, payor, and provider network. The national average negotiated rate is $480. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4240

District of Columbia
$784
2 records
New Hampshire
$707
6 records
Oregon
$686
2 records

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Full National Breakdown

Median
$485
Low
$83
High
$1,400

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
District of Columbia$784
New Hampshire$707
Oregon$686
Missouri$599
Massachusetts$592

↓ Bottom 5

StateAvg Rate
Hawaii$272
Montana$265
Iowa$260
Nebraska$248
Wyoming$234

All States — D4240 Average Rates

District of Columbia
$784
New Hampshire
$707
Oregon
$686
Missouri
$599
Massachusetts
$592
Delaware
$586
Maine
$565
Nevada
$558
Utah
$558
California
$552
Michigan
$550
North Dakota
$545
Arizona
$541
Pennsylvania
$540
South Dakota
$532
Indiana
$528
New York
$521
Colorado
$515
Connecticut
$510
Virginia
$510
New Jersey
$506
Ohio
$498
West Virginia
$494
Wisconsin
$479
Georgia
$467
Washington
$466
Florida
$460
Rhode Island
$453
South Carolina
$449
Texas
$449
Illinois
$437
Maryland
$434
Kentucky
$434
Oklahoma
$429
Louisiana
$417
New Mexico
$407
Kansas
$398
Tennessee
$386
Mississippi
$386
Minnesota
$356
North Carolina
$340
Arkansas
$333
Idaho
$310
Alabama
$307
Hawaii
$272
Montana
$265
Iowa
$260
Nebraska
$248
Wyoming
$234
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
District of Columbia$784$784$739$8282
New Hampshire$707$687$576$9206
Oregon$686$686$618$7532
Missouri$599$555$224$70935
Massachusetts$592$549$260$92015
Delaware$586$586$586$5861
Maine$565$576$549$57612
Nevada$558$535$310$79215
Utah$558$486$479$7093
California$552$592$280$75190
Michigan$550$520$484$7095
North Dakota$545$260$260$1,4004
Arizona$541$592$272$59222
Pennsylvania$540$619$285$70918
South Dakota$532$532$532$5321
Indiana$528$556$405$5568
New York$521$465$235$1,30017
Colorado$515$610$265$70915
Connecticut$510$505$474$5525
Virginia$510$563$263$62915
New Jersey$506$560$235$66120
Ohio$498$494$329$6656
West Virginia$494$469$469$5714
Wisconsin$479$510$332$5958
Georgia$467$474$393$62423
Washington$466$497$272$5806
Florida$460$474$278$75126
Rhode Island$453$453$453$4533
South Carolina$449$481$204$63026
Texas$449$413$280$65026
Illinois$437$421$185$62415
Maryland$434$430$274$60015
Kentucky$434$485$305$55620
Oklahoma$429$421$280$5955
Louisiana$417$410$320$53215
New Mexico$407$412$385$4425
Kansas$398$287$224$7097
Tennessee$386$406$263$5458
Mississippi$386$386$386$3862
Minnesota$356$312$312$67130
North Carolina$340$284$263$57636
Arkansas$333$280$280$4665
Idaho$310$272$272$4264
Alabama$307$285$285$3516
Hawaii$272$272$272$2721
Montana$265$265$265$2653
Iowa$260$185$185$4844
Nebraska$248$246$200$3336
Wyoming$234$234$234$2341
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