Rates› California› D4212

Gingivectomy/Gingivoplasty (Restorative, Per Tooth) (D4212) in California

Negotiated reimbursement rates for D4212 from CMS Transparency in Coverage data. Based on 64 rate records from 63 providers in California.

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Average Negotiated Rate in California
$204
64 rate records · 63 providers
📊 Data updated monthly · Last refresh: March 2026

Provider-Level Rates

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Individual provider rates for D4212 in California. 59 provider records.

Provider City Rate Percentile
General DentistSan Jose$348100th
Oral & Maxillofacial Surgery (MD)Palo Alto$348100th
Oral SurgeonSan Francisco$30995th
Oral SurgeonSan Francisco$30995th
Oral SurgeonSan Francisco$30995th
Oral SurgeonSan Francisco$30995th
General DentistSan Francisco$30689th
Pediatric DentistBelmont$29688th
Pediatric DentistSan Jose$29286th
Oral SurgeonStockton$28784th
General DentistTravis Afb$28784th
EndodontistRocklin$28784th
General DentistSanta Clara$23980th
Oral SurgeonSanta Barbara$22078th
General DentistSan Mateo$21977th
General DentistSouth San Francisco$21775th
General DentistBelmont$20973rd
General DentistLos Angeles$20672nd
General DentistPleasanton$20470th
General DentistHesperia$20369th

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What is D4212?

Gingivectomy/Gingivoplasty (Restorative, Per Tooth) (CDT Code D4212) — These rates represent negotiated amounts between dental insurance payors and providers in California as reported in CMS Transparency in Coverage machine-readable files.

Top States for D4212

Maine
$346
3 records
Delaware
$243
2 records
New York
$232
13 records

44+ more states available with Pro ↓

Full Rate Breakdown

Median Rate
$191
Low
$58
High
$348
25th Percentile
$170
75th Percentile
$218
Data Points
64

Compare D4212 Rates Across All 47 States

Maine
$346
Delaware
$243
New York
$232
Alaska
$232
New Jersey
$223
Connecticut
$214
Wisconsin
$209
New Mexico
$206
California
$204
Indiana
$190
Ohio
$190
Pennsylvania
$180
Colorado
$180
Arizona
$180
Maryland
$179
Michigan
$176
North Dakota
$162
Puerto Rico
$160
New Hampshire
$158
North Carolina
$150
Florida
$145
District of Columbia
$145
Illinois
$145
West Virginia
$142
Georgia
$136
Idaho
$134
Virginia
$133
Rhode Island
$130
Massachusetts
$126
Arkansas
$120
Texas
$120
South Carolina
$120
Missouri
$116
Washington
$110
Wyoming
$109
Minnesota
$107
Kentucky
$100
Utah
$94
Louisiana
$88
Tennessee
$85
Hawaii
$84
Nevada
$79
Mississippi
$76
Nebraska
$74
Alabama
$71
Kansas
$64
Iowa
$63
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