Combined Connective Tissue & Pedicle Graft (D4276) — National Rates

Negotiated reimbursement rates for D4276 across 48 states, sourced from CMS Transparency in Coverage data. 739 rate records.

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National Average Negotiated Rate
$465
739 rate records · 48 states
📊 Data updated monthly · Last refresh: March 2026

About D4276 — Combined Connective Tissue & Pedicle Graft

The D4276 code refers to a Combined Connective Tissue and Pedicle Graft, a technique that utilizes both pedicle and connective tissue grafts to address severe gingival recession. This procedure is indicated when both techniques are necessary to achieve optimal coverage and esthetics. Documentation should include detailed clinical notes, photographs, and measurements of the recession. Insurance reimbursement for this procedure can vary widely based on the payor's policies and the state regulations, with some plans offering comprehensive coverage while others may impose restrictions. The average reimbursement for this procedure is approximately $465.

Reimbursement rates for D4276 vary significantly by state, payor, and provider network. The national average negotiated rate is $465. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4276

Nevada
$867
19 records
Maine
$843
9 records
New York
$798
43 records

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Full National Breakdown

Median
$401
Low
$83
High
$1,293

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Nevada$867
Maine$843
New York$798
West Virginia$755
Virginia$740

↓ Bottom 5

StateAvg Rate
Tennessee$300
North Carolina$283
Idaho$218
Nebraska$217
Montana$208

All States — D4276 Average Rates

Nevada
$867
Maine
$843
New York
$798
West Virginia
$755
Virginia
$740
Minnesota
$640
North Dakota
$633
Indiana
$566
Colorado
$558
South Carolina
$554
Washington
$517
Massachusetts
$514
Kentucky
$509
Florida
$503
New Hampshire
$494
Hawaii
$490
Delaware
$458
Texas
$445
Maryland
$436
Arizona
$428
Michigan
$422
California
$411
Missouri
$410
Pennsylvania
$408
Mississippi
$407
Oregon
$397
Connecticut
$387
Georgia
$374
New Jersey
$367
Utah
$356
Alaska
$355
Alabama
$346
Oklahoma
$343
Kansas
$342
Louisiana
$336
Illinois
$326
Wisconsin
$324
Puerto Rico
$318
District of Columbia
$316
Rhode Island
$312
Ohio
$311
New Mexico
$303
Iowa
$302
Tennessee
$300
North Carolina
$283
Idaho
$218
Nebraska
$217
Montana
$208
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Nevada$867$865$310$1,19019
Maine$843$845$815$8569
New York$798$891$272$1,09843
West Virginia$755$704$704$8573
Virginia$740$894$229$92231
Minnesota$640$640$471$8102
North Dakota$633$336$183$1,2225
Indiana$566$628$236$8376
Colorado$558$461$208$83723
South Carolina$554$425$233$1,29323
Washington$517$555$301$7559
Massachusetts$514$502$125$85116
Kentucky$509$333$239$8167
Florida$503$493$243$83752
New Hampshire$494$438$438$84510
Hawaii$490$333$243$8943
Delaware$458$458$458$4581
Texas$445$451$231$89431
Maryland$436$453$215$89432
Arizona$428$410$243$75518
Michigan$422$445$369$4795
California$411$407$183$1,19079
Missouri$410$383$381$50114
Pennsylvania$408$431$248$82111
Mississippi$407$294$287$7524
Oregon$397$391$329$4764
Connecticut$387$340$329$51215
Georgia$374$343$200$89424
New Jersey$367$272$183$89439
Utah$356$356$350$3622
Alaska$355$390$204$4877
Alabama$346$321$321$3953
Oklahoma$343$367$256$3834
Kansas$342$288$288$4503
Louisiana$336$344$207$4545
Illinois$326$329$275$3714
Wisconsin$324$279$243$75212
Puerto Rico$318$318$238$3972
District of Columbia$316$316$316$3161
Rhode Island$312$312$284$3402
Ohio$311$273$206$87412
New Mexico$303$301$301$34622
Iowa$302$125$125$1,22212
Tennessee$300$333$125$37513
North Carolina$283$243$206$84571
Idaho$218$218$213$2242
Nebraska$217$216$160$2775
Montana$208$208$208$2083
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