Negotiated reimbursement rates for D4273 across 48 states, sourced from CMS Transparency in Coverage data. 716 rate records.
The D4273 code represents an Autogenous Connective Tissue Graft for the first tooth, a procedure where tissue is harvested from the palate to treat gingival recession. This graft is indicated for patients with significant recession affecting aesthetics or tooth sensitivity. Documentation must include clinical findings, photographs, and a rationale for the graft choice. Payors may have different policies regarding coverage, with some requiring evidence of periodontal disease or prior treatments. The average reimbursement for this procedure is approximately $603, but this can vary based on the patient's insurance plan and geographic location.
Reimbursement rates for D4273 vary significantly by state, payor, and provider network. The national average negotiated rate is $603. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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