D4275 is the CDT code for a connective tissue graft made with processed donor material instead of the patient's own tissue, at the first position grafted.
- When to use: The record names a donor product such as an acellular dermal matrix, allograft, or xenograft, and no palatal harvest was performed.
- When not to use: Tissue harvested from the patient is D4273, each added contiguous position is D4285, and a free graft placed on the surface is D4277.
- Billing note: The donor material is included in the fee, so do not bill it separately or as D4265, and record the product name and lot number.
What D4275 covers
D4275 reports a connective tissue graft using processed donor material at the first tooth, implant, or edentulous tooth position in the graft. Instead of harvesting subepithelial tissue from the patient’s palate, the surgeon places a manufactured product (an acellular dermal matrix, an allograft, or a xenograft) under a flap or into a tunnel at the recipient site. Each additional contiguous position in the same graft site goes on D4285, one line each.
The fee includes the recipient-site surgery and the donor material. There is no donor site on this code because there is no harvest; the fee bundles the material instead. A claim that bills the product as a separate supply contradicts the descriptor.
One axis: where the tissue came from
D4275 and D4273 can look identical at the recipient site: same flap or tunnel, same root-coverage or thickening goal, same suturing. The codes split on donor source alone:
- Patient’s own tissue, harvested → D4273, add-on D4283. A second surgical site on the palate.
- Processed donor product, no harvest → D4275, add-on D4285. One surgical site plus a material lot number.
The error is coding from the recipient-site description, which does not differ, instead of the donor source, which does. The operative note, the material log, and the claim have to agree. A product lot number in the chart under a D4273 claim is the version of this error that surfaces in audit, sometimes long after payment. Make the donor source a required field on graft charting so the code choice rests on a recorded fact, not a reconstruction at billing.
Keep each code with its own add-on. D4283 under a D4275 parent crosses the families and reads as a claim built wrong.
Two other graft codes sit nearby. An epithelialized graft placed on the surface is the free gingival graft D4277, and a flap rotated over from next door while still attached is the pedicle graft D4270. A connective tissue graft combined with a double pedicle flap at one tooth is D4276, per tooth.
Coverage and common denials
- Donor-source mismatch. The note or invoice contradicts the code, in either direction, and the claim is reprocessed on review.
- Material billed separately. A separate product line, or a D4265 alongside the graft, is denied as inclusive under plan policies that treat dermal-matrix materials as part of the grafting service.
- Mucogingival criteria not met. The same measurement bar as the rest of the family applies: recession in millimeters, attached-gingiva width, six-point charting, and a functional rationale. One published policy uses a benchmark of 2 mm recession with ≤1 mm attached gingiva, absent other findings. Thresholds vary by plan.
- Cosmetic determination. Many plans exclude grafting solely for appearance; the narrative needs the functional driver.
- Frequency at the site. Contracts commonly limit perio surgery to one procedure per site per 36- or 60-month window. On such plans a prior D4273 at the site counts against the same window, so check history before a regraft.
Documentation that supports the claim
- The product name, type, and lot number in the operative record, the affirmative evidence for non-autogenous coding. Keep product invoices retrievable by patient and date, because post-payment audits on this code start with the material record.
- An operative note describing the recipient-site technique and stating that no autogenous harvest was performed.
- Recession and attached/keratinized gingiva measurements at each grafted position, with charting dated inside the plan’s window.
- The functional rationale: progressive recession, sensitivity, restorative need, or tissue deficiency around a tooth or implant.
- The pre-authorization reference where the plan reviews mucogingival surgery in advance.
FAQs
- What is the dental code for a gum graft using AlloDerm or donor tissue?
- D4275 for the first tooth, implant, or edentulous tooth position, with D4285 for each additional contiguous position in the same graft site. It covers a connective tissue graft using non-autogenous material, a processed product such as an acellular dermal matrix, allograft, or xenograft. The fee includes both the recipient site surgery and the donor material.
- How is D4275 different from D4273?
- Only the source of the graft tissue. D4273 is autogenous: connective tissue harvested from the patient, usually the palate, with the donor-site surgery in the fee. D4275 is non-autogenous: a processed donor product, with no harvest and no palatal wound. The recipient-site technique can be identical, so code from the operative note and material record, which must match the product invoice on review.
- Can I bill the graft material separately from D4275?
- No. The descriptor includes the donor material in the fee, so a separate product line is unbundling. One published Anthem mucogingival policy also states that biological materials such as dermal matrix products are not benefited when submitted with soft tissue grafting. D4265 is for regenerative agents in periodontal defect therapy, not a way to pass graft-product cost through on a D4275 claim.
- Do plans pay D4275 the same as D4273?
- Not necessarily. Some plans allow both at comparable fees, others benefit the graft differently by material, and some exclude soft tissue grafting regardless of technique unless functional criteria are met. Recession and attached-gingiva documentation requirements generally apply as they do for the autogenous codes. Verify benefits and pre-authorize rather than assuming parity with D4273.
- Why did the carrier recode my D4275 to D4273?
- Usually because the operative note described a palatal harvest, which contradicts the non-autogenous code. The reverse also happens: a note naming a processed product gets a D4273 claim recoded to D4275. Carriers match the donor source in the note and any material invoice against the code, and the note wins. Fix the source documentation along with the claim line.
Related codes
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CDT codes are maintained by the American Dental Association. This page is an editorial billing guide, not the official ADA code descriptor. Verify current coverage policies with each carrier before submitting claims.