Negotiated reimbursement rates for D4275 across 48 states, sourced from CMS Transparency in Coverage data. 609 rate records.
The D4275 code is for a Non-Autogenous Connective Tissue Graft for the first tooth, which involves using donor tissue to cover exposed roots due to gingival recession. This procedure is indicated for patients who may not have sufficient tissue available from their own palate. Documentation should include clinical assessments, photographs, and a justification for using non-autogenous material. Coverage and reimbursement can vary significantly by payor, with some requiring pre-authorization and others having specific limitations on graft types. The average reimbursement for this procedure is about $416.
Reimbursement rates for D4275 vary significantly by state, payor, and provider network. The national average negotiated rate is $416. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.
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