HCPCS code Q4104: Wound matrix, integra BMWD2026 Medicare rate & RVUs in Guam
Reports Integra Bilayer Wound Matrix used as a wound covering, paired with the primary application procedure and documented by product and area used.
Medicare pays $144.69 for Q4104 in the office in Guam (Hawaii, Guam, HI). 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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What Q4104 covers
Q4104 identifies Integra Bilayer Wound Matrix (BMWD), a collagen-based wound matrix with a protective outer layer used to cover partial- and full-thickness wounds. Typical settings include wound-care clinics, outpatient surgery, and hospital-based wound treatment. Clinicians may use it for chronic ulcers, surgical wounds, traumatic wounds, or burns; the treating clinician applies the product to the prepared wound.
Report the product with the primary wound or skin-substitute application procedure, not as a stand-alone service. CMS classifies Q4104 as an add-on paid within the primary procedure’s global period. The code represents the product rather than the clinician’s application work; document the product used and the wound area treated, and report units according to the applicable HCPCS descriptor. CMS also identifies Q4104 as technical-component-only, with interpretation covered by a separate code when applicable.
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.
Q4104 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $144.69 | Unavailable |
How the Q4104 rate is calculated
Each of Q4104’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 · Q4104
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 Q4104
The CMS indicators that decide how Q4104 is paid alongside other services.
CMS payment indicators · Q4104
Wound matrix, integra BMWD
| 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. |
Q4104 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4105Skin substituteIntegra DRT or Omnigraft
- Q4105 identifies Integra DRT or Omnigraft. Use Q4104 for Integra BMWD; the product documented as applied determines the supply code.
- Q4108Wound matrixIntegra Matrix
- Q4108 identifies Integra Matrix rather than BMWD. Distinguish them by the specific product used, not simply by the wound being treated.
- Q4102Wound matrixOasis wound matrix
- Q4102 identifies Oasis wound matrix. Q4104 is specific to Integra BMWD, so select the code matching the product used.
Q4104 billing questions
Can Q4104 be reported by itself?
No. CMS identifies it as an add-on that must be billed with a primary procedure; payment falls within that procedure’s global period.
Which application procedure is commonly paired with Q4104?
Pair the product with the applicable skin-substitute application procedure, such as the 15271–15278 family. Select the application code based on the wound site and area treated.
How should units be supported?
Document the BMWD product used and the wound area treated. Report units according to the applicable HCPCS descriptor and the documented quantity.
Does Q4104 include the clinician’s application work?
No. Q4104 identifies the product. The primary procedure represents the application service, and CMS places Q4104 within that procedure’s global period.
What does the technical-component-only designation mean?
CMS identifies Q4104 as technical-component-only and states that interpretation is covered by a separate code when applicable.
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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