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Repair Of A Sinus Opening In The Mouth

New York rates for HCPCS D7261

Surgical closure of an unwanted opening between the mouth and the sinus above the upper back teeth, which can occur after an upper tooth is removed or from other trauma near that area. The gum tissue is repositioned and stitched to seal the opening and prevent food, liquid, or air from passing between the mouth and sinus. It's typically done at the time the opening is discovered, often right after the extraction that caused it.

Rates data updated October 2026.

How much does Repair Of A Sinus Opening In The Mouth cost?

$275

Typical negotiated rate. In New York, October 2026.

Insurers have agreed to pay about $275 for this service. The price depends on where it is billed: about $275 from a physician practice, and about $295 from a hospital or other facility.

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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$275$240 to $302
FacilityA hospital or hospital-owned outpatient department$295$204 to $309

How much rates vary

Facilitymedian $295 · 10th to 90th $204 to $309Professionalmedian $275 · 10th to 90th $224 to $316
$200$500$1K$2Kfacility $295professional $275

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
Aetna
Setting
Facility
Modifier
None
Typical Low
$154.88
Median
$181.97
Typical High
$223.87
Aetna
Setting
Professional
Modifier
None
Typical Low
$181.97
Median
$181.97
Typical High
$223.87
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$239.88
Median
$281.84
Typical High
$316.23
CDPHP
Setting
Facility
Modifier
None
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$4,073.80
Excellus BCBS
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$295.12
Typical High
$295.12
United
Setting
Professional
Modifier
None
Typical Low
$223.87
Median
$223.87
Typical High
$426.58
Univera
Setting
Facility
Modifier
None
Typical Low
$204.17
Median
$295.12
Typical High
$309.03
Univera
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$295.12
Typical High
$295.12

Where New York sits

The same service costs 12.3 times more in Texas than in New Jersey. 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.

New York· 40th of 51

$275

TX $1,905NJ $155

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.