D4273 is the CDT code for an autogenous connective tissue graft procedure, including donor and recipient surgical sites, for the first tooth or edentulous tooth position in the graft. It describes a subepithelial connective tissue graft that uses the patient's own tissue, harvested usually from the palate, to cover an exposed root or augment tissue. It is one of the more common gum grafting procedures.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D4273 claims →Use D4273 for the first tooth or edentulous position in an autogenous subepithelial connective tissue graft. The patient's own connective tissue is harvested from a donor site, usually the palate, and placed at a recipient site to cover an exposed root surface or augment the tissue. The code includes both the donor and recipient surgical sites and reports the first position in the graft.
Common clinical scenarios: Gingival recession exposing a root surface that needs coverage. Thin tissue that requires augmentation around a tooth. A site where the patient's own connective tissue is used as the graft material rather than donor or processed tissue.
Do NOT use D4273 for: Each additional contiguous tooth or edentulous position in the same graft (use D4283). Non-autogenous soft tissue grafts that use donor or processed tissue (use the appropriate non-autogenous graft code). A free gingival graft using epithelialized tissue, which is a different procedure. A pedicle soft tissue graft.
The first position and each additional position in the same graft.
The first tooth or edentulous position in an autogenous connective tissue graft, including the donor and recipient surgical sites. This is the base code for the graft.
Each additional contiguous tooth or edentulous position in the same connective tissue graft. Reported in addition to D4273 when the graft spans more than one position.
Billing tip: Report D4273 once for the first position and D4283 for each additional contiguous position in the same graft. Do not report multiple D4273 units for one continuous graft. The number of positions should match the documented extent of the graft.
D4273 includes both a donor and a recipient surgical site. If the record does not describe harvesting the connective tissue and placing it at the recipient site, the payer cannot confirm an autogenous graft was performed. Document both sites clearly in the operative note.
Reporting D4273 when donor or processed tissue was used is a coding error. D4273 is specifically for autogenous tissue, the patient's own. A graft using non-autogenous material has its own code. The documentation must show the tissue source matches the code.
Each additional contiguous position uses D4283, not another D4273. Reporting multiple first-position codes for a single continuous graft is an error. The number of D4283 units should match the additional positions treated within the same graft.
The claim should support the need for the graft. Charting of the recession, probing measurements, and photos when available strengthen the claim. Without documentation of the condition being treated, the payer may deny the procedure or question necessity.
Document the gingival recession or tissue deficiency being treated, including measurements and the affected tooth positions.
Describe harvesting the autogenous connective tissue from the donor site, usually the palate. This confirms the graft is autogenous.
Describe placing the graft at the recipient site. Both the donor and recipient sites are part of the procedure D4273 reports.
Note the first position reported with D4273 and each additional contiguous position reported with D4283 so the claim reflects the full graft.
Intraoral photos of the recession before treatment strengthen the claim and document the condition that justified the graft.
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Learn about our billing servicesD4273 is the CDT code for an autogenous connective tissue graft procedure, including donor and recipient surgical sites, first tooth or edentulous tooth position in the graft. It describes a subepithelial connective tissue graft that uses the patient's own tissue, a common procedure for treating gum recession.
Autogenous means the graft tissue comes from the patient's own mouth, typically harvested from the palate. D4273 involves both a donor site, where tissue is taken, and a recipient site, where it is placed. This distinguishes it from grafts that use donor or processed tissue.
D4273 covers the first tooth or edentulous tooth position in the graft. Each additional contiguous tooth or edentulous position within the same graft is reported separately with the additional position code, D4283, so the claim reflects the full extent of the graft.
D4273 is the first tooth or edentulous position in an autogenous connective tissue graft. D4283 is each additional contiguous tooth or edentulous position in that same graft. The first position uses D4273 and the rest use D4283.
Yes. Because the graft is autogenous, the procedure includes a donor surgical site where the connective tissue is harvested and a recipient surgical site where it is placed. Both sites are part of the procedure described by D4273.
Common reasons include not documenting both the donor and recipient sites, confusing autogenous grafts with non-autogenous tissue grafts, incorrectly reporting additional positions, missing photos or charting of the recession, and not meeting plan criteria.
Search all 206 CDT codes in our dental coding guide.