Gingivectomy/plasty rest (CPT D4212)

D4212 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.

65 of 4255 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.

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HospitalLocationPosted cashPosted grossMedicare pays× Medicare
Washington County Hospital and Nursing Home Chatom, AL $54.17 — $2,993.40 0.0×
Aurelia Osborn Fox Memorial Hospital Oneonta, NY $85.62 $317.10 $4,138.63 0.0×
Monroe Regional Hospital Aberdeen, MS $100 $100 $2,858.45 0.0×
MetroHealth System Cleveland, OH $101.50 $290 $3,136.68 0.0×
Kaiser Foundation Hospital - South San Francisco South San Francisco, CA $106.96 $191 $4,813.99 0.0×
Kaiser Foundation Hospital-santa Clara Santa Clara, CA $106.96 $191 $4,792.45 0.0×
Kaiser Foundation Hospital - Walnut Creek Walnut Creek, CA $106.96 $191 $4,707.49 0.0×
Kaiser Foundation Hospital and Rehab Center Vallejo, CA $106.96 $191 $4,870.89 0.0×
Kaiser Foundation Hospital - Oakland/richmond Oakland, CA $106.96 $191 $4,849.96 0.0×
Kaiser Foundation Hospital - San Francisco San Francisco, CA $106.96 $191 $4,792.45 0.0×
Kaiser Foundation Hospital - Sacramento Sacramento, CA $106.96 $191 $4,707.49 0.0×
Kaiser Foundation Hospital San Rafael, CA $106.96 $191 $4,702.61 0.0×
Kaiser Foundation Hospital - Fremont Fremont, CA $106.96 $191 $4,792.45 0.0×
Kaiser Foundation Hospital - Redwood City Redwood City, CA $106.96 $191 $4,813.99 0.0×
Kaiser Foundation Hospital-san Jose San Jose, CA $106.96 $191 $4,876.58 0.0×
Kaiser Foundation Hosp So Sacramento Sacramento, CA $106.96 $191 $4,707.49 0.0×
Kaiser Foundation Hospital-santa Rosa Santa Rosa, CA $106.96 $191 $4,559.13 0.0×
Kaiser Foundation Hospital - Fresno Fresno, CA $106.96 $191 $4,264.23 0.0×
Kaiser Foundation Hospital Manteca Manteca, CA $106.96 $191 $4,645.91 0.0×
Kaiser Foundation Hospital - Antioch Antioch, CA $106.96 $191 $4,681.68 0.0×
Kaiser Foundation Hospital - Vacaville Vacaville, CA $106.96 $191 $4,870.89 0.0×
Kaiser Foundation Hospital - Roseville Roseville, CA $106.96 $191 $4,302.85 0.0×
Kaiser Foundation Hospital - San Leandro San Leandro, CA $106.96 $191 $4,793.05 0.0×
Newark-Wayne Community Hospital Newark, NY $128.05 $197 $4,138.63 0.0×
Rochester General Hospital Rochester, NY $128.05 $197 $4,138.63 0.0×
Clifton Springs Hospital and Clinic Clifton Springs, NY $128.05 $197 $4,138.63 0.0×
Unity Hospital of Rochester Rochester, NY $157.60 $197 $4,138.63 0.0×
Unity Specialty Hospital Rochester, NY $157.60 $197 $4,138.63 0.0×
Children's Minnesota - Minneapolis Hospital
range across 2 matching MRF lines
Minneapolis, MN $197–$396 $197–$396 $3,472.43 varies
Cincinnati Children's Hospital Medical Center Cincinnati, OH $218.25 $427.94 $3,230.98 0.1×
Bayside Community Hospital Anahuac, TX $277 $277 $3,330.57 0.1×
Cibola General Hospital Grants, NM $819.06 $1,023.82 $3,282.20 0.2×
Community Hospital East Indianapolis, IN $1,560 $2,600 $3,507.79 0.4×
Lackey Memorial Hospital Forest, MS $2,853 $2,853 $2,993.40 1.0×
Lakeside Medical Center Belle Glade, FL $3,255.33 — $3,462.26 0.9×
Our Lady of the Lake Surgical Hospital Slidell, LA $3,561.05 — $3,010.88 1.2×
Lincoln Medical & Mental Health Center Bronx, NY $3,837.72 — $4,138.63 0.9×
Jacobi Medical Center Bronx, NY $3,837.72 — $4,138.63 0.9×
Elmhurst Hospital Center Elmhurst, NY $3,837.72 — $4,138.63 0.9×
NYC Health + Hospitals/South Brooklyn Health Brooklyn, NY $3,837.72 — $4,138.63 0.9×
Metropolitan Hospital Center New York, NY $3,837.72 — $4,138.63 0.9×
Kings County Hospital Center Brooklyn, NY $3,837.72 — $4,138.63 0.9×
Bellevue Hospital Center New York, NY $3,837.72 — $4,138.63 0.9×
Queens Hospital Center Jamaica, NY $3,837.72 — $4,138.63 0.9×
Harlem Hospital Center New York, NY $3,837.72 — $4,138.63 0.9×
Woodhull Medical & Mental Health Center Brooklyn, NY $3,837.72 — $4,138.63 0.9×
Griffin Hospital Derby, CT $3,877.03 — $3,974.62 1.0×
Highland Hospital Rochester, NY $3,935.40 — $4,138.63 1.0×
Strong Memorial Hospital Rochester, NY $3,935.40 — $4,138.63 1.0×
Valleywise Health Medical Center Phoenix, AZ $4,068.55 — $3,537.87 1.1×
Nyack Hospital Nyack, NY $4,138.63 — $4,138.63 1.0×
Montefiore St. Luke's Cornwall Newburgh, NY $4,138.63 — $4,138.63 1.0×
Henry Ford Macomb Hospital Clinton Township, MI $4,558.89 — $3,303.54 1.4×
Henry Ford Hospital Detroit, MI $4,558.89 — $3,303.54 1.4×
Henry Ford Wyandotte Hospital Wyandotte, MI $4,558.89 — $3,303.54 1.4×
Henry Ford West Bloomfield Hospital West Bloomfield, MI $4,558.89 — $3,303.54 1.4×
Duncan Regional Hospital, Inc Duncan, OK $6,611.96 — $3,188.71 2.1×
Northwest Surgical Hospital Oklahoma City, OK $9,566.13 — $3,188.71 3.0×
Community Hospital, LLC Oklahoma City, OK $9,566.13 — $3,188.71 3.0×
St. Francis Hospital, Roslyn Roslyn, NY — $672 $4,138.63 —
St. Charles Hospital Port Jefferson, NY — $672 $4,138.63 —
Mercy Medical Center Rockville Centre, NY — $672 $4,138.63 —
Good Samaritan Hospital Medical Center West Islip, NY — $672 $4,138.63 —
St. Joseph Hospital Bethpage, NY — $672 $4,138.63 —
St. Catherine of Siena Hospital Smithtown, NY — $672 $4,138.63 —

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.

"Medicare pays" is the facility (technical) rate, matching the posted facility charge; the doctor's separate professional fee is excluded throughout. "—" means Medicare has no comparable facility rate.