go back

Pedicle Gum Tissue Graft

Pennsylvania 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 does Pedicle Gum Tissue Graft cost?

$263

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $263 for this service. The price depends on where it is billed: about $263 from a physician practice, and about $263 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$263$234 to $347
FacilityA hospital or hospital-owned outpatient department$263$263 to $263

How much rates vary

Facilitymedian $263 · 10th to 90th $263 to $661Professionalmedian $263 · 10th to 90th $200 to $372
$200$1K$5K$20Kfacility $263professional $263

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
$263.03
Median
$263.03
Typical High
$263.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$257.04
Typical High
$371.54
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
$346.74
Median
$363.08
Typical High
$363.08
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$660.69
Typical High
$660.69
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$346.74
Median
$346.74
Typical High
$346.74
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$263.03
Typical High
$263.03
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$251.19
Typical High
$354.81

Where Pennsylvania sits

The same service costs 7.6 times more in Minnesota than in Nebraska. 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

$263

MN $1,514NE $200

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.