go back

Gum Tissue Graft From Own Mouth, First Site

New Jersey rates for HCPCS D4273

A dental procedure that takes a small piece of the patient's own tissue and grafts it onto the gums at a tooth, implant, or toothless position. This charge covers the first site treated and includes the work at both the donor and recipient areas.

Rates data updated July 2026.

How much rates vary

Facilitymedian $1,288 · 10th to 90th $234 to $6,457Professionalmedian $380 · 10th to 90th $295 to $468
$500$1K$2K$5Kfacility $1,288professional $380

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
$234.42
Median
$234.42
Typical High
$1,288.25
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$346.74
Typical High
$436.52
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$5,248.07
Typical High
$7,762.47
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$436.52
Typical High
$676.08