Bone Graft For Gum Disease — First Site

Hawaii rates for HCPCS D4263

Placement of bone graft material into an area where gum disease has caused bone loss around a tooth, done to help rebuild lost bone and support for the tooth. This describes the graft placed at the first site treated within one section of the mouth during the same procedure, with any additional sites in that area handled as their own step. It's typically done alongside gum surgery rather than as a stand-alone visit.

Rates data updated July 2026.

How much rates vary

Professionalmedian $135 · 10th to 90th $91 to $170

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Professional Modifier Global Typical Low $91.20 Median $134.90 Typical High $169.82	Professional	Global	$91.20	$134.90	$169.82
Kaiser Permanente Setting Professional Modifier Global Typical Low $457.09 Median $457.09 Typical High $457.09	Professional	Global	$457.09	$457.09	$457.09