Pedicle Soft Tissue Graft (D4270) — National Rates

Negotiated reimbursement rates for D4270 across 47 states, sourced from CMS Transparency in Coverage data. 612 rate records.

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National Average Negotiated Rate
$569
612 rate records · 47 states
📊 Data updated monthly · Last refresh: March 2026

About D4270 — Pedicle Soft Tissue Graft

The D4270 code refers to a Pedicle Soft Tissue Graft, a surgical procedure used to treat gingival recession by relocating tissue from a nearby site to cover exposed roots. Clinical indications include significant gingival recession that may lead to root sensitivity or aesthetic concerns. Proper documentation should include pre-operative photographs, clinical measurements of recession, and a detailed treatment plan. Billing notes should highlight the necessity of the graft for periodontal health. Reimbursement for this procedure can vary significantly by payor and state, with some insurance plans covering the full cost while others may have limitations or require prior authorization. The average reimbursement for this procedure is around $569.

Reimbursement rates for D4270 vary significantly by state, payor, and provider network. The national average negotiated rate is $569. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4270

Maine
$935
3 records
New Hampshire
$796
8 records
Oregon
$731
8 records

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Full National Breakdown

Median
$565
Low
$83
High
$1,375

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Maine$935
New Hampshire$796
Oregon$731
Washington$720
District of Columbia$699

↓ Bottom 5

StateAvg Rate
Iowa$361
Alabama$349
Nebraska$331
Montana$310
Vermont$309

All States — D4270 Average Rates

Maine
$935
New Hampshire
$796
Oregon
$731
Washington
$720
District of Columbia
$699
Wisconsin
$692
Mississippi
$674
Georgia
$667
Massachusetts
$664
New York
$649
California
$644
North Dakota
$641
Oklahoma
$640
West Virginia
$639
Missouri
$637
Nevada
$636
Florida
$622
Connecticut
$612
Ohio
$601
Hawaii
$599
Arizona
$592
South Carolina
$583
Alaska
$582
Illinois
$562
Kentucky
$559
New Jersey
$548
Maryland
$544
Colorado
$535
Virginia
$534
Michigan
$529
Utah
$512
Minnesota
$511
Kansas
$492
Texas
$488
Pennsylvania
$485
New Mexico
$483
Tennessee
$468
Rhode Island
$424
Indiana
$411
Louisiana
$400
North Carolina
$395
Idaho
$390
Iowa
$361
Alabama
$349
Nebraska
$331
Montana
$310
Vermont
$309
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Maine$935$924$880$1,0003
New Hampshire$796$741$741$1,0508
Oregon$731$810$428$8108
Washington$720$746$484$81010
District of Columbia$699$611$472$9665
Wisconsin$692$706$387$9249
Mississippi$674$674$674$6741
Georgia$667$737$401$85016
Massachusetts$664$704$316$86410
New York$649$658$309$1,30732
California$644$650$220$1,016100
North Dakota$641$458$273$1,3754
Oklahoma$640$640$632$6472
West Virginia$639$712$435$7713
Missouri$637$647$328$84613
Nevada$636$586$462$1,01725
Florida$622$686$325$77727
Connecticut$612$612$600$6242
Ohio$601$712$309$75816
Hawaii$599$599$599$5991
Arizona$592$587$347$68717
South Carolina$583$631$347$87928
Alaska$582$582$582$5823
Illinois$562$556$316$8466
Kentucky$559$597$330$8466
New Jersey$548$536$273$77124
Maryland$544$611$320$74119
Colorado$535$468$310$79810
Virginia$534$551$341$6949
Michigan$529$504$330$7784
Utah$512$523$428$5575
Minnesota$511$461$330$6847
Kansas$492$348$220$1,0504
Texas$488$464$309$71914
Pennsylvania$485$428$309$82834
New Mexico$483$481$449$5308
Tennessee$468$436$316$6747
Rhode Island$424$424$424$4241
Indiana$411$334$334$73719
Louisiana$400$336$336$55912
North Carolina$395$325$307$63926
Idaho$390$397$318$4976
Iowa$361$322$277$5244
Alabama$349$364$327$3645
Nebraska$331$277$277$48112
Montana$310$310$310$3103
Vermont$309$309$309$3095
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