Periodontal maint procedures (CPT D4910)
D4910 is the billing code hospitals use for this service. Prices below are each hospital's own posted facility charge.
100 of 4255 hospitals post a price for this code. Hospitals that don't post one are left out. We never guess a number.
Compare interactively: search all codes, set your location →
| Hospital | Location | Posted cash | Posted gross | Medicare pays | × Medicare |
|---|---|---|---|---|---|
| Adventist Health Lodi Memorial | Lodi, CA | $15.33 | $219 | $852.69 | 0.0× |
| Mountains Community Hospital | Lake Arrowhead, CA | $32.80 | $82 | $831.49 | 0.0× |
| Aurelia Osborn Fox Memorial Hospital | Oneonta, NY | $35.10 | $130 | $807 | 0.0× |
| Adventist Health Sonora | Sonora, CA | $37.23 | $219 | $831.49 | 0.0× |
| Adventist Health Reedley | Reedley, CA | $41.61 | $219 | $831.49 | 0.1× |
| Adventist Health Ukiah Valley | Ukiah, CA | $43.80 | $219 | $831.49 | 0.1× |
| Boston Medical Center | Boston, MA | $50.40 | $112 | $774.78 | 0.1× |
| Uci Health-orange | Orange, CA | $52 | $130 | $831.49 | 0.1× |
| Washington County Hospital and Nursing Home | Chatom, AL | $54.17 | — | $583.69 | 0.1× |
| MetroHealth System range across 2 matching MRF lines |
Cleveland, OH | $57.05–$458.85 | $163–$1,311 | $611.63 | varies |
| Adventist Health Tehachapi Valley | Tehachapi, CA | $59.13 | $219 | $831.49 | 0.1× |
| OHSU Hospital and Clinics | Portland, OR | $63.05 | $97 | $725.96 | 0.1× |
| Adventist Health Howard Memorial | Willits, CA | $65.70 | $219 | $831.49 | 0.1× |
| Ventura County Medical Center | Ventura, CA | $82.50 | $165 | $831.49 | 0.1× |
| Newark-Wayne Community Hospital | Newark, NY | $82.55 | $127 | $807 | 0.1× |
| Rochester General Hospital | Rochester, NY | $82.55 | $127 | $807 | 0.1× |
| Clifton Springs Hospital and Clinic | Clifton Springs, NY | $82.55 | $127 | $807 | 0.1× |
| Adventist Health Clearlake | Clearlake, CA | $83.88 | $233 | $831.49 | 0.1× |
| Mammoth Hospital | Mammoth Lakes, CA | $87.50 | $125 | $831.49 | 0.1× |
| Wynn Hospital | Utica, NY | $94.80 | $158 | $807 | 0.1× |
| Contra Costa Regional Medical Center | Martinez, CA | $99 | $99 | $912.89 | 0.1× |
| Cincinnati Children's Hospital Medical Center | Cincinnati, OH | $101.49 | $199 | $630.01 | 0.2× |
| Unity Hospital of Rochester | Rochester, NY | $101.60 | $127 | $807 | 0.1× |
| Unity Specialty Hospital | Rochester, NY | $101.60 | $127 | $807 | 0.1× |
| Nebraska Medical Center | Omaha, NE | $104.65 | $161 | $671.31 | 0.2× |
| Bellevue Medical Center | Bellevue, NE | $104.65 | $161 | $671.31 | 0.2× |
| Kaiser Foundation Hospital - South San Francisco | South San Francisco, CA | $105.84 | $189 | $938.69 | 0.1× |
| Kaiser Foundation Hospital-santa Clara | Santa Clara, CA | $105.84 | $189 | $934.49 | 0.1× |
| Kaiser Foundation Hospital - Walnut Creek | Walnut Creek, CA | $105.84 | $189 | $917.92 | 0.1× |
| Kaiser Foundation Hospital and Rehab Center | Vallejo, CA | $105.84 | $189 | $949.78 | 0.1× |
| Kaiser Foundation Hospital - Oakland/richmond | Oakland, CA | $105.84 | $189 | $945.70 | 0.1× |
| Kaiser Foundation Hospital - San Francisco | San Francisco, CA | $105.84 | $189 | $934.49 | 0.1× |
| Kaiser Foundation Hospital - Sacramento | Sacramento, CA | $105.84 | $189 | $917.92 | 0.1× |
| Kaiser Foundation Hospital | San Rafael, CA | $105.84 | $189 | $916.97 | 0.1× |
| Kaiser Foundation Hospital - Fremont | Fremont, CA | $105.84 | $189 | $934.49 | 0.1× |
| Kaiser Foundation Hospital - Redwood City | Redwood City, CA | $105.84 | $189 | $938.69 | 0.1× |
| Kaiser Foundation Hospital-san Jose | San Jose, CA | $105.84 | $189 | $950.89 | 0.1× |
| Kaiser Foundation Hosp So Sacramento | Sacramento, CA | $105.84 | $189 | $917.92 | 0.1× |
| Kaiser Foundation Hospital-santa Rosa | Santa Rosa, CA | $105.84 | $189 | $888.99 | 0.1× |
| Kaiser Foundation Hospital - Fresno | Fresno, CA | $105.84 | $189 | $831.49 | 0.1× |
| Kaiser Foundation Hospital Manteca | Manteca, CA | $105.84 | $189 | $905.91 | 0.1× |
| Kaiser Foundation Hospital - Antioch | Antioch, CA | $105.84 | $189 | $912.89 | 0.1× |
| Kaiser Foundation Hospital - Vacaville | Vacaville, CA | $105.84 | $189 | $949.78 | 0.1× |
| Kaiser Foundation Hospital - Roseville | Roseville, CA | $105.84 | $189 | $839.02 | 0.1× |
| Kaiser Foundation Hospital - San Leandro | San Leandro, CA | $105.84 | $189 | $934.61 | 0.1× |
| Plumas District Hospital | Quincy, CA | $141.60 | $177 | $831.49 | 0.2× |
| Adventist Health Mendocino Coast | Fort Bragg, CA | $144.54 | $219 | $831.49 | 0.2× |
| Bayside Community Hospital | Anahuac, TX | $154 | $154 | $649.43 | 0.2× |
| Mary Imogene Bassett Hospital | Cooperstown, NY | $160.95 | $596.12 | $807 | 0.2× |
| Strong Memorial Hospital range across 2 matching MRF lines |
Rochester, NY | $165.75–$767.37 | — | $807 | varies |
| Brooklyn Hospital Center - Downtown Campus | Brooklyn, NY | $170.22 | $170.22 | $807 | 0.2× |
| Westchester Medical Center | Valhalla, NY | $171 | $171 | $807 | 0.2× |
| Maimonides Medical Center | Brooklyn, NY | $193 | $193 | $807 | 0.2× |
| Roswell Park Comprehensive Cancer Center | Buffalo, NY | $209.20 | $209.20 | $807 | 0.3× |
| Endeavor Health Clinical Operations | Evanston, IL | $210 | $210 | $692.79 | 0.3× |
| Swedish Hospital | Chicago, IL | $210 | $210 | $692.79 | 0.3× |
| Kaleida Health | Buffalo, NY | $247 | $247 | $807 | 0.3× |
| Fred Hutch Cancer Center | Seattle, WA | $271.80 | $302 | $750.73 | 0.4× |
| Bear Valley Community Hospital | Big Bear Lake, CA | $273 | $390 | $831.49 | 0.3× |
| Mount Sinai Hospital | New York, NY | $360 | $400 | $807 | 0.4× |
| Mount Sinai West | New York, NY | $360 | $400 | $807 | 0.4× |
| Mount Sinai Brooklyn | Brooklyn, NY | $360 | $400 | $807 | 0.4× |
| Highland Hospital | Rochester, NY | $767.37 | — | $807 | 1.0× |
| Valleywise Health Medical Center | Phoenix, AZ | $793.33 | — | $689.86 | 1.1× |
| Nyack Hospital | Nyack, NY | $807 | — | $807 | 1.0× |
| Montefiore St. Luke's Cornwall | Newburgh, NY | $807 | — | $807 | 1.0× |
| Henry Ford Macomb Hospital | Clinton Township, MI | $888.94 | — | $644.16 | 1.4× |
| Henry Ford Hospital | Detroit, MI | $888.94 | — | $644.16 | 1.4× |
| Henry Ford Wyandotte Hospital | Wyandotte, MI | $888.94 | — | $644.16 | 1.4× |
| Henry Ford West Bloomfield Hospital | West Bloomfield, MI | $888.94 | — | $644.16 | 1.4× |
| Hilton Head Medical Center | Hilton Head Island, SC | $1,071.79 | — | $601.28 | 1.8× |
| East Cooper Medical Center | Mount Pleasant, SC | $1,071.79 | — | $601.28 | 1.8× |
| Coastal Carolina Medical Center | Hardeeville, SC | $1,071.79 | — | $601.28 | 1.8× |
| Dunes Surgical Hospital | Dakota Dunes, SD | $1,347.69 | — | $660.49 | 2.0× |
| Lakeside Medical Center | Belle Glade, FL | $1,668.91 | — | $675.11 | 2.5× |
| Our Lady of the Lake Surgical Hospital | Slidell, LA | $1,825.64 | — | $587.10 | 3.1× |
| Northwest Surgical Hospital | Oklahoma City, OK | $1,865.31 | — | $621.77 | 3.0× |
| Community Hospital, LLC | Oklahoma City, OK | $1,865.31 | — | $621.77 | 3.0× |
| Lincoln Medical & Mental Health Center | Bronx, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Jacobi Medical Center | Bronx, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Elmhurst Hospital Center | Elmhurst, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| NYC Health + Hospitals/South Brooklyn Health | Brooklyn, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Metropolitan Hospital Center | New York, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Kings County Hospital Center | Brooklyn, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Bellevue Hospital Center | New York, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Queens Hospital Center | Jamaica, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Harlem Hospital Center | New York, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Woodhull Medical & Mental Health Center | Brooklyn, NY | $1,967.49 | $301.88 | $807 | 2.4× |
| Griffin Hospital | Derby, CT | $1,987.64 | — | $775.02 | 2.6× |
| Baptist Hospital of Miami | Miami, FL | $2,312.05 | $3,557 | $675.11 | 3.4× |
| Duncan Regional Hospital, Inc | Duncan, OK | $3,389.76 | — | $621.77 | 5.5× |
| Erie County Medical Center | Buffalo, NY | — | $183 | $807 | — |
| Upstate University Hospital | Syracuse, NY | — | $199 | $807 | — |
| St. Francis Hospital, Roslyn | Roslyn, NY | — | $212 | $807 | — |
| St. Charles Hospital | Port Jefferson, NY | — | $212 | $807 | — |
| Mercy Medical Center | Rockville Centre, NY | — | $212 | $807 | — |
| Good Samaritan Hospital Medical Center | West Islip, NY | — | $212 | $807 | — |
| St. Joseph Hospital | Bethpage, NY | — | $212 | $807 | — |
| St. Catherine of Siena Hospital | Smithtown, NY | — | $212 | $807 | — |
| Jackson Memorial Hospital | Miami, FL | — | $2,503 | $675.11 | — |
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.