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HCPCS code Q4101: Skin substitute, apligraf, per square centimeter2026 Medicare rate & RVUs in North Carolina

Q4101 reports Apligraf supplied for wound treatment, measured by area and billed with the procedure used to apply the product.

CMS RVU26DEffective Oct 1, 2026One payment locality

In North Carolina, Medicare pays $118.73 for Q4101 in the office.

$118.73Office (non-facility)
Not available in this settingHospital or facility
−6.7%vs the national office rate ($127.26)

Check a contract rate as a % of Medicare · Q4101 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open Q4101 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What Q4101 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How North Carolina compares for Q4101

Across 109 of 109 payment localities, the office rate for Q4101 runs from $109.31 in Arkansas to $183.51 in Santa Clara County, CA. North Carolina pays $118.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

Q4101 in North Carolina vs other payment areas
  1. North Carolina · this page$118.73
  2. Los Angeles, CA · California$150.55+$31.82
  3. Washington, DC area · District of Columbia$149.91+$31.18
  4. Miami, FL · Florida$132.47+$13.74
  5. Chicago, IL · Illinois$127.89+$9.16
  6. Manhattan, NY · New York$147.87+$29.14
  7. Alaska · Alaska$135.53+$16.80

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

Q4101 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$111.35—
ArkansasArkansas$109.31—
ArizonaArizona$123.31—
Bakersfield, CACalifornia$139.47—
Chico, CACalifornia$139.47—
El Centro, CACalifornia$139.47—
Fresno, CACalifornia$139.47—
Hanford, CACalifornia$139.47—

Q4101 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$109.31

$161.49

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
Q4101 office rate range by state
State / territoryOffice rate rangeLocalities
AK$135.531
AL$111.351
AR$109.311
AZ$123.311
CA$139.47–$183.5129
CO$135.401
CT$137.061
DC$149.911
DE$125.731
FL$121.66–$132.473
GA$113.51–$129.292
GU$144.691
HI$144.691
IA$116.441
ID$117.081
IL$116.19–$130.694
IN$117.971
KS$115.041
KY$113.131
LA$112.62–$119.752
MA$134.00–$151.952
MD$128.78–$149.913
ME$117.08–$126.112
MI$116.19–$122.802
MN$130.951
MO$109.70–$121.153
MS$109.571
MT$127.261
NC$118.731
ND$127.261
NE$117.461
NH$132.471
NJ$138.97–$147.622
NM$116.701
NV$127.381
NY$120.89–$151.315
OH$116.191
OK$113.641
OR$126.75–$141.382
PA$116.82–$132.472
PR$128.661
RI$131.461
SC$117.591
SD$127.261
TN$115.681
TX$115.80–$134.648
UT$119.621
VA$125.09–$149.912
VI$128.661
VT$125.981
WA$134.00–$156.142
WI$121.911
WV$110.591
WY$127.261

See Q4101 in every payment locality

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

Office or facility?

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

18,201

Code
Q4101
Physician work
0.00
Practice expense
3.81
Malpractice
0.00

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for Q4101 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense3.81× 0.9333.5547
Malpractice0.00× 0.6390.0000
Total RVUs3.5547
Conversion factor× 33.4009

Office rate, North Carolina$118.73

Office: (0 × 1 + 3.81 × 0.933 + 0 × 0.639) × $33.4009 = $118.73

Open Q4101 in the RVU calculator

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

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical3Technical component only.

Codes related to Q4101

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to Q4101
CodeHow it relatesOffice range, North Carolina
Primary code
15271Skin substitute graft, first 25 cm², trunk/limbsPrimary skin-substitute application procedure for qualifying trunk and extremity wounds.$148.61
15275Skin substitute, face and other specified sitesPrimary skin-substitute application procedure for qualifying wounds at other specified sites.$151.60
Used instead
Q4102Wound matrix, oasis wound matrixOasis wound matrix is a different skin-substitute product.$118.73
Q4121Skin substitute, theraSkin per square centimeterTheraSkin is a different skin-substitute product.$118.73

How Q4101 has changed in North Carolina

Q4101 · Office / nonfacility

$118.73

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    No ratechanged to$118.73

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$118.73Not available in this settingRVU26D
2026-07-01$118.73Not available in this settingRVU26C
2026-04-01$118.73Not available in this settingRVU26B
2026-01-01$118.73Not available in this settingRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Separate payment rules applySeparate payment rules applyRVU24B
2024-03-09Separate payment rules applySeparate payment rules applyRVU24AR
2024-01-01Separate payment rules applySeparate payment rules applyRVU24A
2023-10-01Separate payment rules applySeparate payment rules applyRVU23D
2023-07-01Separate payment rules applySeparate payment rules applyRVU23C
2023-04-01Separate payment rules applySeparate payment rules applyRVU23B
2023-01-01Separate payment rules applySeparate payment rules applyRVU23A
2022-10-01Separate payment rules applySeparate payment rules applyRVU22D
2022-07-01Separate payment rules applySeparate payment rules applyRVU22C
2022-04-01Separate payment rules applySeparate payment rules applyRVU22B
2022-01-01Separate payment rules applySeparate payment rules applyRVU22A
2021-10-01Separate payment rules applySeparate payment rules applyRVU21D
2021-07-01Separate payment rules applySeparate payment rules applyRVU21C
2021-04-01Separate payment rules applySeparate payment rules applyRVU21B
2021-01-01Separate payment rules applySeparate payment rules applyRVU21A
2020-10-01Separate payment rules applySeparate payment rules applyRVU20D
2020-07-01Separate payment rules applySeparate payment rules applyRVU20C
2020-04-01Separate payment rules applySeparate payment rules applyRVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Separate payment rules applySeparate payment rules applyRVU19D
2019-07-01Separate payment rules applySeparate payment rules applyRVU19C
2019-04-01Separate payment rules applySeparate payment rules applyRVU19B
2019-01-01Separate payment rules applySeparate payment rules applyRVU19A
2018-10-01Separate payment rules applySeparate payment rules applyRVU18D
2018-07-01Separate payment rules applySeparate payment rules applyRVU18C
2018-04-01Separate payment rules applySeparate payment rules applyRVU18B
2018-01-01Separate payment rules applySeparate payment rules applyRVU18AR1
2017-10-01Separate payment rules applySeparate payment rules applyRVU17D
2017-07-01Separate payment rules applySeparate payment rules applyRVU17C
2017-04-01Separate payment rules applySeparate payment rules applyRVU17B
2017-01-01Separate payment rules applySeparate payment rules applyRVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price Q4101 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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

Show the CMS file lines behind this rate
RVUs for Q4101PPRRVU2026_Oct_nonQPP.csv, line 18,201 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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