Free Soft Tissue Graft (Each Additional Tooth) (D4278) — National Rates

Negotiated reimbursement rates for D4278 across 47 states, sourced from CMS Transparency in Coverage data. 629 rate records.

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National Average Negotiated Rate
$324
629 rate records · 47 states
📊 Data updated monthly · Last refresh: March 2026

About D4278 — Free Soft Tissue Graft (Each Additional Tooth)

D4278 is designated for free soft tissue grafts for each additional tooth following the first. This procedure is typically performed in conjunction with D4277 when multiple sites require grafting due to periodontal issues. Clinical indications include extensive gingival recession or the need for additional tissue for successful implant placement. Proper documentation should include the number of teeth involved, clinical photographs, and a thorough treatment plan. Reimbursement for D4278 averages around $324, but payor policies can differ widely, with some plans providing full coverage while others may impose limitations or exclusions. It is crucial for dental billing professionals to confirm the specifics of the patient's insurance coverage to ensure proper reimbursement.

Reimbursement rates for D4278 vary significantly by state, payor, and provider network. The national average negotiated rate is $324. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4278

Maine
$532
8 records
New Hampshire
$468
6 records
North Dakota
$456
3 records

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Full National Breakdown

Median
$316
Low
$83
High
$1,200

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Maine$532
New Hampshire$468
North Dakota$456
Puerto Rico$439
California$423

↓ Bottom 5

StateAvg Rate
Connecticut$218
Oklahoma$217
Montana$211
Louisiana$175
Iowa$142

All States — D4278 Average Rates

Maine
$532
New Hampshire
$468
North Dakota
$456
Puerto Rico
$439
California
$423
Virginia
$420
Massachusetts
$412
Oregon
$410
New York
$386
New Jersey
$380
Colorado
$354
District of Columbia
$353
Delaware
$351
Washington
$341
South Dakota
$341
Florida
$341
Pennsylvania
$341
Kansas
$338
Missouri
$331
Georgia
$329
Arizona
$329
Wisconsin
$329
New Mexico
$317
Michigan
$315
South Carolina
$313
Nevada
$304
Hawaii
$300
Alaska
$298
Illinois
$298
Kentucky
$297
Texas
$294
Ohio
$281
Rhode Island
$272
Indiana
$269
Maryland
$269
North Carolina
$269
Tennessee
$263
Utah
$262
Nebraska
$236
Minnesota
$234
Alabama
$224
Mississippi
$220
Connecticut
$218
Oklahoma
$217
Montana
$211
Louisiana
$175
Iowa
$142
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Maine$532$522$522$6008
New Hampshire$468$472$237$6306
North Dakota$456$207$186$9753
Puerto Rico$439$439$439$4391
California$423$384$220$68787
Virginia$420$460$222$47320
Massachusetts$412$418$256$5554
Oregon$410$429$352$4298
New York$386$338$186$1,20020
New Jersey$380$446$232$49317
Colorado$354$331$291$45231
District of Columbia$353$336$218$4736
Delaware$351$351$235$4672
Washington$341$325$224$42913
South Dakota$341$341$341$3413
Florida$341$358$164$48213
Pennsylvania$341$293$253$4507
Kansas$338$216$168$6303
Missouri$331$362$113$47313
Georgia$329$301$220$52211
Arizona$329$346$224$40518
Wisconsin$329$340$220$39211
New Mexico$317$334$220$3616
Michigan$315$316$228$40322
South Carolina$313$296$195$52227
Nevada$304$263$239$50213
Hawaii$300$300$180$4298
Alaska$298$298$207$3892
Illinois$298$269$164$46914
Kentucky$297$285$241$47319
Texas$294$331$160$49713
Ohio$281$277$113$3829
Rhode Island$272$272$256$2892
Indiana$269$228$220$43610
Maryland$269$218$218$47312
North Carolina$269$222$143$52237
Tennessee$263$293$176$47321
Utah$262$268$214$2974
Nebraska$236$236$205$2662
Minnesota$234$224$170$39024
Alabama$224$220$220$27134
Mississippi$220$220$220$2201
Connecticut$218$218$218$2181
Oklahoma$217$217$217$2172
Montana$211$211$211$2113
Louisiana$175$164$160$27315
Iowa$142$113$113$2249
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