Apically Positioned Flap (D4245) — National Rates

Negotiated reimbursement rates for D4245 across 46 states, sourced from CMS Transparency in Coverage data. 517 rate records.

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National Average Negotiated Rate
$342
517 rate records · 46 states
📊 Data updated monthly · Last refresh: March 2026

About D4245 — Apically Positioned Flap

D4245 refers to an Apically Positioned Flap procedure, which is performed to access the root surfaces of teeth for surgical intervention, often in cases of periodontal disease. Clinical indications include the need for access to the underlying bone and root surfaces for debridement or to facilitate other surgical procedures. Documentation for billing should include detailed notes on the patient's periodontal condition, the rationale for the flap procedure, and any additional treatments performed during the same visit. Reimbursement for D4245 can vary significantly by payor and state, with some insurance plans covering the procedure fully while others may only provide partial reimbursement or require prior authorization. Average reimbursement is around $342, but dental billing professionals should verify coverage specifics with individual payors to ensure accurate claims submission and payment expectations.

Reimbursement rates for D4245 vary significantly by state, payor, and provider network. The national average negotiated rate is $342. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4245

Maine
$884
4 records
Colorado
$535
13 records
Washington
$515
6 records

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Full National Breakdown

Median
$330
Low
$83
High
$919

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Maine$884
Colorado$535
Washington$515
Nevada$506
Ohio$498

↓ Bottom 5

StateAvg Rate
Alaska$228
Idaho$203
Rhode Island$192
Tennessee$190
Hawaii$163

All States — D4245 Average Rates

Maine
$884
Colorado
$535
Washington
$515
Nevada
$506
Ohio
$498
New Hampshire
$472
Indiana
$447
Arizona
$425
Massachusetts
$412
Puerto Rico
$404
Michigan
$399
South Carolina
$371
Florida
$369
Oregon
$367
California
$354
Missouri
$348
New York
$344
Utah
$329
District of Columbia
$327
Oklahoma
$323
Georgia
$315
Texas
$315
Connecticut
$308
Iowa
$305
Illinois
$297
Wisconsin
$293
Pennsylvania
$293
Nebraska
$291
Louisiana
$290
Maryland
$283
Kansas
$281
West Virginia
$279
Kentucky
$269
Arkansas
$268
Minnesota
$267
North Carolina
$253
New Mexico
$252
Alabama
$247
North Dakota
$243
New Jersey
$243
Virginia
$234
Alaska
$228
Idaho
$203
Rhode Island
$192
Tennessee
$190
Hawaii
$163
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Maine$884$884$850$9194
Colorado$535$680$232$68713
Washington$515$580$163$6166
Nevada$506$505$313$72216
Ohio$498$561$203$59612
New Hampshire$472$412$412$8938
Indiana$447$455$172$7074
Arizona$425$415$163$85013
Massachusetts$412$412$296$5248
Puerto Rico$404$404$404$4041
Michigan$399$381$332$4853
South Carolina$371$365$178$60429
Florida$369$384$216$50022
Oregon$367$410$280$4103
California$354$413$159$52265
Missouri$348$340$259$50924
New York$344$354$140$66731
Utah$329$329$310$3482
District of Columbia$327$243$241$4973
Oklahoma$323$323$256$3902
Georgia$315$360$159$43510
Texas$315$304$192$46016
Connecticut$308$320$258$3324
Iowa$305$305$280$3304
Illinois$297$326$194$3746
Wisconsin$293$270$192$4207
Pennsylvania$293$243$164$45712
Nebraska$291$277$277$3324
Louisiana$290$290$290$2901
Maryland$283$284$164$41225
Kansas$281$280$159$35914
West Virginia$279$208$181$5618
Kentucky$269$190$183$5154
Arkansas$268$261$204$3393
Minnesota$267$192$192$47114
North Carolina$253$268$158$3659
New Mexico$252$252$230$2732
Alabama$247$238$210$2926
North Dakota$243$188$140$5396
New Jersey$243$184$159$50346
Virginia$234$201$175$39516
Alaska$228$228$156$2992
Idaho$203$163$163$2695
Rhode Island$192$192$167$2182
Tennessee$190$200$159$2004
Hawaii$163$163$163$1631
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