HCPCS code Q4101: Skin substitute, apligraf, per square centimeter2026 Medicare rate & RVUs in California
Q4101 reports Apligraf supplied for wound treatment, measured by area and billed with the procedure used to apply the product.
Medicare pays $139.47–$183.51 for Q4101 in the office in California, from Bakersfield, CA to Santa Clara County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What Q4101 covers
Q4101 represents Apligraf, a living skin substitute used to support healing of chronic wounds such as venous leg ulcers and diabetic foot ulcers. Wound-care physicians, surgeons, podiatrists, and other clinicians may apply it in outpatient wound clinics or other settings where these wounds are treated. The code represents the product, not the clinician’s application service.
Report the quantity based on the square centimeters of Apligraf supplied, and document the wound, product used, and amount applied. Q4101 is an add-on code: report it only with a primary application procedure, and its payment falls within that procedure’s global period. CMS assigns no physician work RVUs and assigns practice-expense RVUs. CMS classifies Q4101 as technical-component-only; a separate code covers interpretation.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where Q4101 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$139.47 to $183.51
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $139.47 | Unavailable |
| Chico, CA | $139.47 | Unavailable |
| El Centro, CA | $139.47 | Unavailable |
| Fresno, CA | $139.47 | Unavailable |
| Hanford, CA | $139.47 | Unavailable |
| Los Angeles, CA | $150.55 | Unavailable |
| Madera, CA | $139.47 | Unavailable |
| Marin County, CA | $179.43 | Unavailable |
| Merced, CA | $139.47 | Unavailable |
| Modesto, CA | $139.47 | Unavailable |
| Napa, CA | $167.73 | Unavailable |
| Oxnard, CA | $150.42 | Unavailable |
| Redding, CA | $139.47 | Unavailable |
| Rest of California | $139.47 | Unavailable |
| Riverside, CA | $139.47 | Unavailable |
| Sacramento, CA | $148.00 | Unavailable |
| Salinas, CA | $147.49 | Unavailable |
| San Benito County, CA | $183.51 | Unavailable |
| San Diego, CA | $152.20 | Unavailable |
| San Francisco, CA | $179.43 | Unavailable |
| San Luis Obispo, CA | $144.95 | Unavailable |
| Santa Clara County, CA | $183.51 | Unavailable |
| Santa Cruz, CA | $154.62 | Unavailable |
| Santa Maria, CA | $148.38 | Unavailable |
| Santa Rosa, CA | $156.27 | Unavailable |
| Stockton, CA | $139.47 | Unavailable |
| Vallejo, CA | $167.73 | Unavailable |
| Visalia, CA | $139.47 | Unavailable |
| Yuba City, CA | $139.47 | Unavailable |
How the Q4101 rate is calculated
Each of Q4101’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · Q4101
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense3.81
3.81 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
3.8100
Conversion factor
$33.4009
Medicare rate
$127.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4101
The CMS indicators that decide how Q4101 is paid alongside other services.
CMS payment indicators · Q4101
Skin substitute, apligraf, per square centimeter
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4101 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 15271Skin substitute graftFirst 25 cm², trunk/limbs
- 15271 reports the application procedure for qualifying trunk and extremity wounds; Q4101 reports the Apligraf product used with that procedure.
- 15275Skin substituteFace and other specified sites
- 15275 reports the application procedure for qualifying wounds at specified sites such as the head, neck, hands, feet, or genitalia; Q4101 reports the product.
- Q4102Wound matrixOasis wound matrix
- Q4102 identifies Oasis wound matrix, not Apligraf. Select the product code that matches the skin substitute supplied.
Q4101 billing questions
Does Q4101 report the Apligraf application?
No. Q4101 reports the Apligraf product; report the applicable skin-substitute application procedure separately as the primary service.
What is the unit of service?
Q4101 is measured per square centimeter. Document the wound area treated and the amount of Apligraf used.
Can Q4101 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure, such as the applicable skin-substitute application code.
How does the global-period rule affect payment?
Q4101 is paid within the primary procedure’s global period. Its payment is tied to that procedure rather than treated as a separate standalone service.
Does Q4101 include an interpretation?
No. CMS classifies Q4101 as technical-component-only, and a separate code covers interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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