Code: D4264

Description:
Bone replce graft each add
Other Descriptions:
Related codes:
Code: D4260
Osseous Surgery (including Elevation Of A Full Thickness Flap And Closure) – Four Or More Contiguous
Code: D4261
Osseous Surgery (including Elevation Of A Full Thickness Flap And Closure) – One To Three Contiguous
Code: D4263
Bone Replacement Graft – Retained Natural Tooth – First Site In Quadrant
Code: D4265
Bio mtrls to aid soft/os reg
Code: D4266
Guided Tissue Regeneration - Resorbable Barrier, Per Site
Code: D4267
Guided Tissue Regeneration - Nonresorbable Barrier, Per Site (includes Membrane Removal)
Code: D4268
Surgical Revision Procedure, Per Tooth
Hawaii
Hospital Address Code Price Last Updated
Hilo Medical Center 1190 Waianuenue Ave, Hilo D4264 $1,607 [source] 3 years ago
Kona Community Hospital 79-1019 Haukapila St, Kealakekua D4264 $1,607 [source] 3 years ago

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR §180.