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Pedicle Gum Tissue Graft

Hawaii rates for HCPCS D4270

A gum surgery that moves healthy tissue from next to a receded area over to cover an exposed tooth root, keeping the tissue attached at one edge so it keeps its own blood supply. It is used to treat gum recession, protect the root from sensitivity and further wear, and improve the appearance of the gumline.

Rates data updated July 2026.

How much rates vary

Professionalmedian $457 · 10th to 90th $355 to $457
$500.0professional $457

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
Professional
Modifier
Global
Typical Low
$354.81
Median
$457.09
Typical High
$457.09