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