Almost everything on a cosmetic dentistry price list is optional. A gum graft is the exception. Gum recession exposes the root of the tooth, and the American Academy of Periodontology describes graft surgery as covering that exposed root to help prevent additional recession and bone loss. CareCredit puts it plainly: left untreated, recession raises the risk of decay and tooth loss.
That changes how you shop for it. Because a graft is usually medically indicated rather than purely cosmetic, dental plans often pay a share, and the number you are quoted depends heavily on how many teeth are in the graft. Grafts are priced per site, not per mouth. This guide covers cash prices by graft type and by CDT code, the difference between a per-tooth fee and a whole-case average, and where the discounts actually are. All figures are the most recent published data available as of August 2026.
What Does a Gum Graft Cost Without Insurance?
Two very different numbers circulate for this procedure, and both are right. The per-tooth figures below come from practices and institutions that publish their full fee schedules by CDT code. The whole-case figure comes from CareCredit’s national cost study, conducted by ASQ360 for Synchrony in 2024, which averages entire treatment episodes.
| Service or line item | Low | Average | High |
|---|---|---|---|
| Connective tissue graft (D4273), first tooth | $965 | $1,270 | $1,602 |
| Donor-tissue / allograft (D4275), first tooth | $1,032 | $1,093 | $1,154 |
| Pedicle (lateral) graft (D4270), first tooth | n/a | $1,015 | n/a |
| Free gingival graft (D4277), first tooth | n/a | $905 | n/a |
| Whole gum graft case, national average | $2,120 | $2,742 | $4,982 |
| Multi-tooth soft tissue graft case, DC metro practice | $2,900 | n/a | $4,500 |
| Periodontist consult, exam and imaging | $159 | $230 | $500 |
| Deep cleaning first, per quadrant (D4341) | $255 | n/a | $386 |
On the connective tissue graft, the spread between offices is the story. Denver Dental Specialties, a Colorado periodontal practice that publishes its fee disclosure, lists D4273 at $965. Boston University’s dental health centers list the same code at $1,339. Maynard Family Dentists, a Massachusetts general practice, lists it at $1,602. Delaware’s Medicaid program, whose dental fee schedule took effect April 1, 2025, allows $1,174.42. Four published sources, one code, a $637 spread, averaging about $1,270.
The whole-case average sits well above any single code because it includes everything around the surgery. CareCredit’s national average is $2,742 with a range of $2,120 to $4,982, and the study specifically lists the number of teeth treated, the size and location of the graft sites, whether you need local anesthetic or general anesthesia, X-rays and aftercare, and the origin of the donor tissue as the factors that move it. Precision Periodontics, a Washington DC and Northern Virginia practice, quotes a soft tissue graft at $2,900 to $4,500, which lands in the same band.
Geography does real work here. In CareCredit’s state table, an average connective tissue graft runs $2,341 in Oklahoma, $2,359 in Mississippi and $2,373 in Alabama, against $3,478 in California, $4,013 in Hawaii, $3,248 in Massachusetts and $3,142 in the District of Columbia. That is a $1,600 swing on the same operation.
What Drives the Price
How many teeth are in the graft. This is the biggest lever and the easiest one to miss. Every graft code on the published schedules is written for the first tooth or first site. Additional adjacent sites in the same graft are billed on their own. A single-tooth graft at $965 and a three-site graft at the same practice are not remotely the same invoice, which is why the CareCredit case average is roughly double a single-site fee.
The type of graft. A connective tissue graft takes tissue from beneath the surface of your palate and is the most common approach, per CareCredit. A free gingival graft takes tissue from the palate surface and uses more of it. A pedicle graft borrows tissue from the gum right next to the recession and is only possible when there is enough nearby tissue, which is why CareCredit lists it as the less expensive option. On published fee schedules the spread across types is narrower than you would expect: $905 for the free gingival code, $1,015 for the pedicle code and $965 to $1,602 for the connective tissue code.
Where the tissue comes from. Autogenous grafts use your own tissue. Allografts use banked human donor tissue. Xenografts use tissue from another species. CareCredit states donor tissue generally costs more, but the published schedules point the other way: Boston University lists the autogenous code at $1,339 and the non-autogenous code at $1,032, and Delaware Medicaid allows $1,174.42 and $1,153.78. Given the disagreement, get both fees quoted rather than assuming either direction.
Anesthesia and sedation. CareCredit lists local versus general anesthesia as a direct cost driver, and notes that most grafts are done under local anesthesia while a nervous patient or a more extensive case may call for general. The AAP notes periodontists are trained to administer sedation or anesthesia during treatment. Sedation is almost always a separate line on the treatment plan, so ask for it in writing.
What has to happen first. CareCredit notes you may need a deep cleaning or even extractions before graft surgery. That is not a small add-on: scaling and root planing runs $255 per quadrant at the Colorado periodontal practice and $386 per quadrant at the Massachusetts general practice, and four quadrants of it can cost as much as the graft.
The workup. Precision Periodontics tells patients to be prepared for a first periodontist visit costing up to $500, covering a full periodontal exam and any needed X-rays. Published exam fees back that up: a comprehensive periodontal evaluation (D0180) is $230 at the Colorado practice and $159 at the Massachusetts practice, and a limited-view CBCT scan is $365 at the Colorado practice.
A Note on the Pinhole Technique
The Pinhole Surgical Technique (PST) is a scalpel-free alternative that repositions existing gum tissue through a small entry point rather than transplanting tissue from the palate. It is marketed heavily, and it is worth knowing one thing before you price it: it does not appear on any of the published fee schedules cited in this guide, including the periodontal practice’s own fee disclosure and the state Medicaid schedule. That means there is no reference price to check a quote against and no allowed amount for a plan to key off. If a practice recommends it, ask what it is billed as, ask for the fee per tooth in writing, and price a conventional graft at two other offices for comparison.
Cash Price vs. Insurance
This is where a gum graft differs from whitening, veneers or bonding. Because recession is a disease process rather than an appearance problem, plans generally do treat grafts as covered periodontal surgery. Boston University’s schedule shows the graft codes at 50% to 60% coverage under its plans, against 100% for preventive work, which is the typical shape of a dental benefit.
Two caveats keep that from being as good as it sounds. CareCredit notes some plans only cover a graft when a specific amount of recession is documented, so a borderline case can be denied on measurement. And most dental plans carry an annual maximum: if a full case runs $2,742 and the cap is $1,500, the plan runs out partway through and the rest is yours.
CareCredit also flags a path many people miss. Health insurance plans sometimes pay for medically necessary dental surgery, and treatment for more severe periodontal disease is more likely to be covered by medical insurance, especially when it involves surgery. If you have medical coverage but no dental plan, that is worth asking about explicitly before you write it off.
Paying cash still has leverage. Ask directly for the self-pay fee, ask whether it drops if you pay in full at the surgery date, and get the answer written next to each CDT code. You can check what you are quoted against typical cash rates with our fair price checker.
How to Pay Less
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Get the treatment plan by code and by site count. Ask for the graft code (D4270, D4273, D4275 or D4277), how many sites are being grafted, and the fee for each additional site. Two quotes are only comparable once you can see the site count, because the same practice can produce a $965 quote and a $2,900 quote for the same diagnosis depending on how many teeth are included.
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Get a second opinion on how many teeth need grafting. The site count is a clinical judgment, and it is the number with the largest dollar consequence. A general dentist referral and an independent periodontist opinion can disagree, and the difference between one site and three is thousands of dollars.
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Try a dental school or teaching clinic. The University of Washington School of Dentistry states its teaching clinic runs roughly 30 to 40 percent below a private dental practice, with specialty clinics generally below private specialty practice. Note that UW specifically says it does not offer payment plans or a sliding fee scale, so plan for payment at each appointment. Precision Periodontics also points patients toward dental schools and continuing-education programs as the main discount route.
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Price the allograft and the autogenous graft separately. Since the published schedules disagree with CareCredit about which is cheaper, this is a genuine coin flip you can win by asking. On Boston University’s schedule the donor-tissue graft is $307 less than the autogenous one for the first tooth.
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Use a community health center if money is tight. Federally qualified health centers price dental care on a sliding income scale and many have periodontal capacity or referral relationships. Our guide to free and sliding-scale clinics covers how to find one and what to ask about surgical services.
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Get a written good-faith estimate and stage the payments. Grafts are scheduled, not urgent, which means you have time to get the number in writing before you commit. Our explainer on hospital price transparency rules covers your right to an estimate up front, and if you have already been billed and the number is wrong or unaffordable, our playbook on negotiating medical bills has the scripts.
The Bottom Line
For a single tooth, plan on roughly $905 to $1,602 plus a $159 to $500 workup. For a realistic multi-tooth case, plan on the CareCredit range of $2,120 to $4,982, with the middle of that band around $2,742.
Price the alternatives while you are at it. If recession has already cost you a tooth, our guides to dental implants, dental crowns and tooth extraction have those numbers, and if the underlying problem is gum disease rather than brushing technique, the deep cleaning covered in our teeth cleaning guide is usually the first bill, not the graft. Getting the site count and the code in writing is what turns an intimidating quote into an ordinary comparison.