Combined Connective Tissue Graft (Each Add'l Tooth) (D4286) — National Rates

Negotiated reimbursement rates for D4286 across 49 states, sourced from CMS Transparency in Coverage data. 485 rate records.

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National Average Negotiated Rate
$328
485 rate records · 49 states
📊 Data updated monthly · Last refresh: March 2026

About D4286 — Combined Connective Tissue Graft (Each Add'l Tooth)

D4286 refers to combined connective tissue grafts for each additional tooth. This procedure may be indicated when both autogenous and non-autogenous grafting techniques are utilized to achieve optimal results in periodontal therapy. Proper documentation is crucial and should include detailed clinical notes, photographs, and a comprehensive treatment plan. The average reimbursement for D4286 is approximately $328, but as with other grafting procedures, reimbursement can vary widely based on the patient's insurance plan and state regulations. It is important to verify coverage details with payors to avoid potential denials and ensure that the patient is informed of any financial responsibilities.

Reimbursement rates for D4286 vary significantly by state, payor, and provider network. The national average negotiated rate is $328. Data sourced from CMS Transparency in Coverage machine-readable files, updated monthly.

Top Paying States for D4286

Maine
$602
5 records
Oregon
$492
4 records
New Hampshire
$475
9 records

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Full National Breakdown

Median
$315
Low
$5
High
$683

Highest & Lowest Reimbursement States

↑ Top 5

StateAvg Rate
Maine$602
Oregon$492
New Hampshire$475
Missouri$433
Minnesota$432

↓ Bottom 5

StateAvg Rate
North Carolina$210
Nebraska$209
Arkansas$187
Montana$177
Vermont$176

All States — D4286 Average Rates

Maine
$602
Oregon
$492
New Hampshire
$475
Missouri
$433
Minnesota
$432
Connecticut
$389
New York
$381
Massachusetts
$379
Georgia
$373
California
$364
Washington
$361
Kentucky
$351
Colorado
$342
Arizona
$338
Michigan
$338
New Jersey
$336
Pennsylvania
$334
Ohio
$329
Florida
$319
Wyoming
$318
Iowa
$314
Texas
$311
Kansas
$311
Delaware
$310
Virginia
$309
Maryland
$293
Alabama
$292
Illinois
$292
Hawaii
$289
New Mexico
$288
Utah
$273
Louisiana
$272
District of Columbia
$270
Alaska
$265
Tennessee
$264
Nevada
$264
Oklahoma
$264
West Virginia
$262
Mississippi
$257
Idaho
$247
Indiana
$238
North Dakota
$231
Wisconsin
$221
South Carolina
$219
North Carolina
$210
Nebraska
$209
Arkansas
$187
Montana
$177
Vermont
$176
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State-by-State Comparison Table

StateAverageMedianMinMaxRecords
Maine$602$578$550$6835
Oregon$492$492$443$5404
New Hampshire$475$458$458$6149
Missouri$433$370$220$59327
Minnesota$432$455$200$63210
Connecticut$389$434$226$45111
New York$381$352$176$65015
Massachusetts$379$458$173$4587
Georgia$373$376$286$45531
California$364$344$156$58158
Washington$361$419$164$4628
Kentucky$351$342$203$5008
Colorado$342$302$177$43617
Arizona$338$352$244$4044
Michigan$338$325$272$4163
New Jersey$336$362$156$42918
Pennsylvania$334$322$176$5208
Ohio$329$232$176$5569
Florida$319$288$185$38630
Wyoming$318$318$318$3181
Iowa$314$314$212$4162
Texas$311$314$168$52520
Kansas$311$220$173$59310
Delaware$310$310$230$3902
Virginia$309$315$195$36031
Maryland$293$287$183$45813
Alabama$292$292$292$2921
Illinois$292$308$216$3436
Hawaii$289$302$240$3155
New Mexico$288$288$275$3026
Utah$273$273$273$2731
Louisiana$272$248$248$34710
District of Columbia$270$270$270$2701
Alaska$265$265$265$2651
Tennessee$264$279$181$27911
Nevada$264$264$264$2644
Oklahoma$264$281$205$2894
West Virginia$262$262$262$2621
Mississippi$257$257$257$2571
Idaho$247$227$227$2985
Indiana$238$238$191$2852
North Dakota$231$173$156$4805
Wisconsin$221$221$221$2211
South Carolina$219$209$5$41317
North Carolina$210$204$175$25316
Nebraska$209$212$173$22012
Arkansas$187$187$164$2102
Montana$177$177$177$1771
Vermont$176$176$176$1765
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