Impacted Tooth Removal – Soft Tissue Only

Connecticut rates for HCPCS D7220

Surgical removal of a tooth that has not fully erupted but is covered only by gum tissue, not by bone. The gum is opened to expose and remove the tooth, without needing to remove any surrounding jawbone. This is the least involved category of impacted-tooth surgery, though it is still more than a simple extraction of a fully erupted tooth.

Rates data updated October 2026.

How much rates vary

Professionalmedian $178 · 10th to 90th $129 to $331

Distribution of negotiated rates across all payers (price axis is log-scale). 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 None Typical Low $123.03 Median $288.40 Typical High $288.40	Professional	None	$123.03	$288.40	$288.40
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $338.84	Professional	None	$128.82	$177.83	$338.84