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Gum And Bone Surgery — Smaller Area

Pennsylvania rates for HCPCS D4261

Surgery to treat gum disease by lifting the gum tissue to access and reshape the bone underneath, performed on a smaller area covering a few neighboring teeth (or spaces where teeth used to be) in one section of the mouth. The bone is reshaped to reduce disease-related pockets and irregular contours, then the gum is stitched back into place. It's a smaller version of the same surgery done over a wider area when more teeth are involved at once.

Rates data updated July 2026.

How much does Gum And Bone Surgery — Smaller Area cost?

$251

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $251 for this service. The price depends on where it is billed: about $251 from a physician practice, and about $251 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$251$224 to $263
FacilityA hospital or hospital-owned outpatient department$251$251 to $251

How much rates vary

Facilitymedian $251 · 10th to 90th $251 to $251Professionalmedian $251 · 10th to 90th $204 to $295
$200$1K$5K$20Kfacility $251professional $251

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$251.19
Typical High
$295.12
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$257.04
Typical High
$257.04
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$234.42
Typical High
$269.15

Where Pennsylvania sits

The same service costs 8.9 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 38th of 51

$251

MN $1,698VT $191

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.