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