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Impacted Tooth Removal – Soft Tissue Only

New York 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 July 2026.

How much does Impacted Tooth Removal – Soft Tissue Only cost?

$166

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $166 for this service. The price depends on where it is billed: about $135 from a physician practice, and about $3,631 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 8 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$135$120 to $151
FacilityA hospital or hospital-owned outpatient department$3,631$2,291 to $4,169

How much rates vary

Facilitymedian $3,631 · 10th to 90th $617 to $5,012Professionalmedian $135 · 10th to 90th $110 to $240
$100.0$1.0K$10.0Kfacility $3,631professional $135

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
$100.00
Median
$109.65
Typical High
$131.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$123.03
Typical High
$239.88
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,630.78
Typical High
$5,011.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$144.54
Typical High
$257.04
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$4,073.80
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$257.04
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$257.04
Typical High
$257.04
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$50,118.72
Median
$53,703.18
Typical High
$75,857.76
United
Setting
Professional
Modifier
Global
Typical Low
$25.12
Median
$54.95
Typical High
$208.93
Univera
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$134.90
Typical High
$134.90
Univera
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$134.90
Typical High
$257.04

Where New York sits

The same service costs 5.5 times more in Minnesota than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

New York $166 · 17th of 51
MN $490VT $89.13

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.