Gingival Flap Surgery — 1–3 Teeth (Per Quad) (D4241) — National Rates

Negotiated reimbursement rates for D4241 across 42 states, sourced from CMS Transparency in Coverage data. 552 rate records.

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National Average Negotiated Rate
$277
552 rate records · 42 states
📊 Data updated monthly · Last refresh: March 2026

About D4241 — Gingival Flap Surgery — 1–3 Teeth (Per Quad)

D4241 is the CDT code for gingival flap surgery involving one to three teeth, billed on a per quadrant basis. This procedure is indicated for patients with localized periodontal issues that require surgical intervention to access the underlying structures for treatment. Documentation should include a thorough periodontal evaluation, treatment plan, and any relevant radiographs. The average reimbursement for D4241 is around $277, but this amount can vary based on the payor and state. Insurance coverage may differ, with some plans requiring prior authorization or specific clinical justification, so it is important to verify benefits before proceeding with treatment.

Reimbursement rates for D4241 vary significantly by state, payor, and provider network. The national average negotiated rate is $277. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4241

North Dakota
$530
6 records
New York
$429
16 records
Georgia
$396
22 records

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Full National Breakdown

Median
$252
Low
$83
High
$1,671

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
North Dakota$530
New York$429
Georgia$396
District of Columbia$368
Missouri$357

↓ Bottom 5

StateAvg Rate
Illinois$180
Indiana$177
Wisconsin$165
Arkansas$151
Nebraska$107

All States — D4241 Average Rates

North Dakota
$530
New York
$429
Georgia
$396
District of Columbia
$368
Missouri
$357
Virginia
$342
Ohio
$330
South Carolina
$324
Maine
$320
Iowa
$317
Oregon
$312
Michigan
$311
Alaska
$308
Utah
$297
Washington
$291
Hawaii
$286
California
$281
Nevada
$275
Arizona
$267
Connecticut
$260
Kansas
$248
Florida
$240
New Jersey
$239
Massachusetts
$238
Mississippi
$236
Pennsylvania
$236
Tennessee
$228
Maryland
$228
Texas
$226
Oklahoma
$226
Colorado
$223
Louisiana
$217
North Carolina
$214
Minnesota
$195
Kentucky
$195
Alabama
$188
Idaho
$183
Illinois
$180
Indiana
$177
Wisconsin
$165
Arkansas
$151
Nebraska
$107
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
North Dakota$530$265$117$1,2006
New York$429$280$117$1,67116
Georgia$396$450$172$51222
District of Columbia$368$310$293$5023
Missouri$357$396$112$44534
Virginia$342$344$266$41418
Ohio$330$396$164$46019
South Carolina$324$304$102$53823
Maine$320$320$315$3252
Iowa$317$83$83$1,2005
Oregon$312$300$300$36615
Michigan$311$296$136$44510
Alaska$308$308$308$3081
Utah$297$272$208$4456
Washington$291$308$217$30812
Hawaii$286$286$239$3332
California$281$281$172$44556
Nevada$275$299$112$31821
Arizona$267$257$184$40010
Connecticut$260$242$206$3375
Kansas$248$246$112$44510
Florida$240$218$139$47322
New Jersey$239$246$139$33013
Massachusetts$238$200$200$3327
Mississippi$236$240$160$3044
Pennsylvania$236$211$159$44510
Tennessee$228$239$144$28914
Maryland$228$262$137$3057
Texas$226$221$168$44853
Oklahoma$226$226$198$2532
Colorado$223$208$136$44512
Louisiana$217$236$160$26612
North Carolina$214$223$132$30413
Minnesota$195$168$112$35023
Kentucky$195$162$152$3016
Alabama$188$148$112$3043
Idaho$183$170$136$32310
Illinois$180$160$83$31210
Indiana$177$143$143$2453
Wisconsin$165$165$165$1651
Arkansas$151$148$148$19013
Nebraska$107$107$107$1071
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