Distal/Proximal Wedge Procedure (D4274) — National Rates

Negotiated reimbursement rates for D4274 across 43 states, sourced from CMS Transparency in Coverage data. 504 rate records.

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National Average Negotiated Rate
$272
504 rate records · 43 states
📊 Data updated monthly · Last refresh: March 2026

About D4274 — Distal/Proximal Wedge Procedure

D4274 is the code for a Distal/Proximal Wedge Procedure, which is performed to gain access to the tooth roots for scaling and root planing or to improve the contour of the gingiva. Clinical indications include periodontal disease or the need for improved access during surgical procedures. Documentation should include clinical notes detailing the need for the procedure and any related periodontal measurements. Reimbursement rates can differ widely among payors, with some states having specific guidelines for coverage. The average reimbursement for this procedure is around $272.

Reimbursement rates for D4274 vary significantly by state, payor, and provider network. The national average negotiated rate is $272. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4274

Connecticut
$475
5 records
Maine
$408
2 records
Florida
$395
26 records

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Full National Breakdown

Median
$240
Low
$68
High
$599

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Connecticut$475
Maine$408
Florida$395
North Dakota$385
Georgia$381

↓ Bottom 5

StateAvg Rate
Idaho$138
Arkansas$137
Wyoming$117
Iowa$114
Nebraska$112

All States — D4274 Average Rates

Connecticut
$475
Maine
$408
Florida
$395
North Dakota
$385
Georgia
$381
Nevada
$357
South Carolina
$352
New York
$325
West Virginia
$309
Utah
$308
Virginia
$284
Massachusetts
$265
Indiana
$257
Michigan
$248
Colorado
$244
Maryland
$244
New Jersey
$243
Washington
$240
Wisconsin
$239
Pennsylvania
$231
Missouri
$227
Arizona
$221
Minnesota
$220
California
$210
Ohio
$210
New Mexico
$201
Illinois
$195
Kansas
$188
Hawaii
$184
Louisiana
$179
Texas
$179
North Carolina
$176
Kentucky
$166
Alabama
$157
Oklahoma
$154
Puerto Rico
$146
Mississippi
$142
Tennessee
$140
Idaho
$138
Arkansas
$137
Wyoming
$117
Iowa
$114
Nebraska
$112
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Connecticut$475$474$465$4945
Maine$408$408$395$4202
Florida$395$392$172$54426
North Dakota$385$459$130$4596
Georgia$381$410$166$42787
Nevada$357$228$190$59917
South Carolina$352$335$149$52716
New York$325$310$176$52721
West Virginia$309$309$309$3091
Utah$308$308$155$4602
Virginia$284$287$146$33810
Massachusetts$265$240$188$3995
Indiana$257$257$139$3752
Michigan$248$248$233$2622
Colorado$244$208$182$39510
Maryland$244$227$137$29818
New Jersey$243$252$153$33013
Washington$240$290$136$2953
Wisconsin$239$272$102$2896
Pennsylvania$231$244$159$2536
Missouri$227$233$140$26224
Arizona$221$232$136$3037
Minnesota$220$204$188$2515
California$210$188$144$37583
Ohio$210$174$174$3928
New Mexico$201$192$192$2267
Illinois$195$162$157$31211
Kansas$188$140$140$2627
Hawaii$184$184$136$2322
Louisiana$179$138$108$2913
Texas$179$165$160$2375
North Carolina$176$146$87$41020
Kentucky$166$166$152$1802
Alabama$157$157$148$1666
Oklahoma$154$154$154$1541
Puerto Rico$146$146$146$1461
Mississippi$142$142$102$1832
Tennessee$140$102$102$31017
Idaho$138$136$136$1434
Arkansas$137$133$102$1735
Wyoming$117$117$117$1171
Iowa$114$113$68$1867
Nebraska$112$112$112$1121
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