Autogenous Connective Tissue Graft (First Tooth) (D4273) — National Rates

Negotiated reimbursement rates for D4273 across 48 states, sourced from CMS Transparency in Coverage data. 716 rate records.

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National Average Negotiated Rate
$603
716 rate records · 48 states
📊 Data updated monthly · Last refresh: March 2026

About D4273 — Autogenous Connective Tissue Graft (First Tooth)

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.

Top Paying States for D4273

Connecticut
$958
25 records
Maine
$908
10 records
Virginia
$905
37 records

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Full National Breakdown

Median
$539
Low
$83
High
$2,175

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Connecticut$958
Maine$908
Virginia$905
New Hampshire$905
Nevada$892

↓ Bottom 5

StateAvg Rate
Tennessee$340
Idaho$313
Oklahoma$231
Iowa$230
Nebraska$180

All States — D4273 Average Rates

Connecticut
$958
Maine
$908
Virginia
$905
New Hampshire
$905
Nevada
$892
Vermont
$859
District of Columbia
$845
New York
$798
Indiana
$780
West Virginia
$739
Wisconsin
$739
Alaska
$733
South Carolina
$687
Maryland
$648
Ohio
$636
Pennsylvania
$635
California
$633
Kentucky
$626
Georgia
$582
Kansas
$578
New Jersey
$565
Massachusetts
$563
Colorado
$561
North Dakota
$536
Missouri
$535
Washington
$526
Alabama
$519
Hawaii
$504
New Mexico
$496
Oregon
$482
Delaware
$472
Florida
$468
North Carolina
$461
Texas
$457
Illinois
$442
Mississippi
$432
Minnesota
$431
Rhode Island
$429
Utah
$405
Arizona
$402
Louisiana
$400
Michigan
$384
Wyoming
$372
Tennessee
$340
Idaho
$313
Oklahoma
$231
Iowa
$230
Nebraska
$180
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Connecticut$958$980$754$98025
Maine$908$971$383$97510
Virginia$905$937$344$99437
New Hampshire$905$859$859$1,02411
Nevada$892$895$250$1,20532
Vermont$859$859$859$8591
District of Columbia$845$881$485$1,1426
New York$798$742$121$2,17518
Indiana$780$819$454$1,0304
West Virginia$739$751$539$9144
Wisconsin$739$785$390$8198
Alaska$733$733$733$7331
South Carolina$687$688$403$1,22728
Maryland$648$596$312$93718
Ohio$636$550$256$86815
Pennsylvania$635$575$428$98011
California$633$574$200$1,02795
Kentucky$626$518$333$8439
Georgia$582$601$379$1,00821
Kansas$578$555$180$1,0244
New Jersey$565$588$275$66719
Massachusetts$563$500$409$1,00816
Colorado$561$534$300$92512
North Dakota$536$290$252$1,3104
Missouri$535$555$316$71112
Washington$526$572$333$6085
Alabama$519$490$441$6865
Hawaii$504$434$312$8394
New Mexico$496$534$314$5348
Oregon$482$482$391$5722
Delaware$472$472$406$5382
Florida$468$422$121$94141
North Carolina$461$467$252$97142
Texas$457$411$121$93732
Illinois$442$396$368$81910
Mississippi$432$432$432$4321
Minnesota$431$478$155$47812
Rhode Island$429$427$328$5333
Utah$405$318$250$8686
Arizona$402$387$200$87349
Louisiana$400$384$224$6316
Michigan$384$357$300$5556
Wyoming$372$372$372$3721
Tennessee$340$294$200$93720
Idaho$313$300$285$3929
Oklahoma$231$231$231$2311
Iowa$230$180$121$3685
Nebraska$180$180$180$1806
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