Complete-cost guide

Gum grafting cost

Soft tissue grafting is priced per site or per tooth, and the largest coverage question is whether the plan classifies the treatment as functional or cosmetic, because that distinction determines whether benefits apply at all.

Updated August 20, 2026Not clinically reviewed · status

Part of See Cost guides. Related: More on Sleep apnea oral appliance cost · More on Sinus lift cost · Crown lengthening cost explained · More on Root canal retreatment cost

Grafting is priced per site, so the number of teeth being treated drives the total directly, and multi-site cases add up quickly. The variable that most affects whether you pay all of it yourself is how the plan classifies the treatment: grafting to address progressing recession, inadequate attached tissue or a sensitive, decaying root is more likely to be considered than grafting done to improve appearance. Insurers commonly require documented measurements before approving benefits, which is a practical reason to have recession charted and photographed instead of described. The other cost worth planning for is treating the cause, brushing technique, occlusal trauma or active periodontal disease, because grafting into an unchanged cause invites a repeat. Using your own palatal tissue for the graft avoids a separate material cost but adds a second surgical site with its own discomfort, while a processed graft matrix skips that donor wound at the price of the material itself.

Published fees for the coded services

Fee per unit of the procedure code, in US dollars
ServiceDelta Dental of Washington plan, 2023Maryland Medicaid, 2025
Pedicle soft tissue graft (D4270)$335Not listed
Autogenous connective tissue graft, first tooth (D4273)$423Not listed
Gingivectomy or gingivoplasty, 1 to 3 teeth per quadrant (D4211)$63Not listed

Private offices can charge more, and fees differ by region and case. Sources: the Delta Dental of Washington fee schedule (as of June 8, 2023) and the Maryland Healthy Smiles 2025 fee schedule. For a fee lookup by ZIP code, see FAIR Health Consumer.

What moves the number

Cost drivers

FactorDetail
Number of sitesPriced per tooth or per site, so treating several adjacent recessions costs proportionally more.
Tissue sourceYour own palatal tissue versus a processed graft material. The latter avoids a donor site but adds a material cost.
TechniqueConnective tissue graft, free gingival graft, tunnel technique and pedicle flaps differ in complexity and time.
Who performs itPeriodontist or general dentist, with different fee schedules.
Preliminary treatmentActive periodontal disease must be treated first, and that is a separate cost.
Cause managementA night appliance for occlusal trauma, or occlusal adjustment, where those contributed.

Benefits

The functional versus cosmetic distinction

This single distinction determines whether your plan contributes. Grafting documented as addressing a lack of attached tissue, progressing recession, root sensitivity or root decay is far more likely to be considered a covered benefit than grafting recorded as improving the appearance of a long-looking tooth. Insurers commonly require recession depth and attached tissue measurements before approving, so having those recorded, with photographs showing progression over time where possible, is not bureaucratic box-ticking; it is what supports the claim. Because denials here are common, a pretreatment estimate is particularly worthwhile.

Complete cost

Line items to expect

01

Assessment, charting and photographs establishing the baseline

02

The graft procedure, per site

03

Graft material where a processed matrix is used

04

Palatal stent or dressing where the palate is the donor site

05

Sedation, if used

06

Suture removal and post-operative reviews

07

Periodontal treatment beforehand, where disease is present

08

A night appliance where occlusal trauma contributed

Red flags

What should make you pause

!

Grafting proposed with no discussion of what caused the recession

!

No measurements or photographs establishing that recession is actually progressing

!

A promise of complete root coverage without reference to the defect shape

!

Multiple sites recommended at once with no staging option offered

!

Grafting planned while active periodontal disease is untreated

!

No explanation of donor site options or the discomfort involved

Insurance

A gum graft is coverage's functional-versus-cosmetic question

Cigna lists gum grafts among major restorative care. The bigger question is why the graft is being done. A graft that treats recession threatening a tooth or supporting gum health may be covered as a functional procedure, and one done for appearance may be excluded. The plan decides from the diagnosis, the measurements and the notes submitted. Check what documentation the plan wants, such as photographs, recession measurements or X-rays, and whether it approves the graft in advance. Ask, too, whether it pays per tooth or per site, since the count changes the estimate.

Ask for the plan's approval in writing before the day of surgery.

One site or several

Grafts are priced by site

FactorDetail
One toothPriced for a single site. Find out whether the fee includes the donor site and follow-up.
Several adjacent teethA single procedure may treat a few neighboring teeth. Find out whether it is priced per tooth or as one.
Both sides of the mouthOften done in separate stages. Ask how that changes cost and healing.
Graft materialFind out whether tissue comes from your own mouth or from a processed source, and how that affects the fee.

Who does the work

Periodontist or general dentist

A periodontist has advanced training in the gums and in the tissue that supports the teeth, and performs most gum grafting. A general dentist may also perform simple grafts. Find out about the provider's experience with cases like yours, what technique is proposed, how long healing takes and what happens if the graft does not hold. If your recession has a cause such as aggressive brushing or gum disease, ask how it will be addressed so the problem does not return.

Lowering the bill

Ways to reduce cost without lowering the standard

01

Call a dental school or advanced-education periodontal program to find out whether it treats recession and how its fees are set

02

Ask whether watching a mild case is a reasonable first step, and what would trigger treatment

03

Get itemized estimates from two providers for the same teeth

04

Ask how the plan classifies the graft and whether it will approve it in advance

05

Ask what follow-up and maintenance are included

Questions people ask

Common questions

01

Will insurance cover a gum graft?

It depends heavily on whether the plan classifies it as functional or cosmetic. Grafting to address progressing recession, inadequate attached tissue, root sensitivity or root decay is more likely to be considered than grafting for appearance alone. Plans commonly require documented recession depth and attached tissue measurements before approving. Because denials are frequent here, submitting a pretreatment estimate with the measurements attached is genuinely worth the delay.

02

Why is it priced per tooth?

Because each site is a separate surgical procedure with its own preparation, graft placement and suturing, even when several are treated in one appointment. That means a multi-site case costs proportionally more and can consume an annual maximum quickly. If cost is a constraint, ask whether treating the most affected sites first and staging the rest is clinically reasonable in your case.

03

Is a graft using my own tissue cheaper than a donor material?

Not necessarily: using your own palatal tissue avoids a material cost but adds a second surgical site, more chair time and more post-operative discomfort, and may require a stent. Processed graft materials add a material cost but avoid the donor site entirely. The choice should be made on clinical and personal grounds, including how you feel about a palatal wound, instead of on a marginal price difference.

04

What if the graft does not achieve full coverage?

Partial coverage is a realistic outcome in some defect shapes, particularly where the bone between the teeth has been lost, and that limit should be explained before surgery, not discovered after. Ask what degree of coverage is expected in your case and what happens if it falls short. Whether a second procedure would be offered, and at what cost. Getting that answer in writing beforehand avoids a difficult conversation later.

05

Do I have to pay to treat the cause as well?

Usually yes, and it is money better spent than skipped. If heavy brushing caused the recession, correcting technique costs nothing. If occlusal trauma contributed, a night appliance or bite adjustment is a separate cost. If periodontal disease is active, it must be treated first and that is its own course of treatment. Grafting into an unchanged cause is a predictable way to pay twice.

06

Does treating multiple recession sites at once cost less per site than treating them separately?

Sometimes somewhat, since certain preparation and donor-site steps can be shared across adjacent sites in one session, but each site is still individually assessed and priced: ask for an itemized quote covering all planned sites instead of assuming a bulk discount.

07

Is a follow-up visit to check healing included in the gum grafting fee?

Typically yes for a standard post-operative check, but confirm how many are included, since healing and stability assessment for a soft-tissue graft can take longer to fully settle than many other dental procedures.

08

Can gum recession get worse and require a bigger, more expensive graft if I wait?

In some cases yes, particularly where the underlying cause (brushing trauma, occlusal forces, thin tissue biotype) remains unaddressed: ask whether your specific recession is stable or progressing, since that affects whether waiting carries a real cost risk.

09

Does gum grafting around an implant cost differently than around a natural tooth?

Sometimes, since the surrounding anatomy and the goals (protecting an implant from peri-implant disease versus covering a natural root) can differ, potentially affecting the specific technique used and its fee: ask how the plan for your implant site compares with a natural-tooth graft.

10

Is sedation typically needed for gum grafting, and does that add cost?

Local anesthetic is standard and usually sufficient; additional sedation is not always necessary but is available for anxious patients as its own separately billed item, similar to other oral surgical procedures.

11

Does using a processed graft matrix material cost more than a donor tissue graft in the long run?

Material costs vary by product and brand, and there is no universal answer. Get a quote for both approaches with the specific materials named so you can compare instead of assuming one type of material is always more expensive.

12

Is follow-up periodontal maintenance after a gum graft billed separately from routine cleanings?

If periodontal disease is present, ongoing periodontal maintenance is billed under its own code and interval, separate from a routine cleaning, and this continues indefinitely regardless of whether a graft was also performed at some point.

13

Does dental insurance cover gum grafts?

Sometimes. Cigna lists gum grafts as major restorative care. Plans often distinguish a functional graft, which treats recession that threatens a tooth or gum health, from a cosmetic one, which may be excluded. Ask what documentation the plan needs and get its approval in writing.

14

Is gum grafting priced per tooth?

Usually by site or by tooth, though some offices price a group of neighboring teeth as one procedure. Check what the quote covers, including the donor tissue, the surgery and the follow-up visits. Compare the count of sites and the technique as well as the totals.

15

Do I need a graft for mild recession?

Not always. A mild case may be watched with better home care, and a dentist can measure it over time. Treatment may be suggested if recession is progressing or threatens a tooth. Check with your dentist what would change the recommendation, and consider a second opinion for elective work.

Related glossary terms

Sources

  1. Oral Health TopicsAmerican Dental AssociationAccessed 2026-08-17
  2. Medicare Dental CoverageCenters for Medicare & Medicaid ServicesAccessed 2026-08-17
  3. Dental HMO vs. PPO PlansCigna HealthcareAccessed 2026-09-24
  4. What Is a Dental PPO Plan?MetLife Oral Fitness LibraryAccessed 2026-09-24
  5. Periodontal (Gum) DiseaseNational Institute of Dental and Craniofacial ResearchAccessed 2026-08-17
  6. Finding Dental CareNational Institute of Dental and Craniofacial ResearchAccessed 2026-09-23