HCPCS code Q4105: Skin substitute, integra DRT or Omnigraft2026 Medicare rate & RVUs

Medicare pays $127.26 for Q4105 nationally in the office. Local office rates run $109.31–$183.51.

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

What Q4105 covers

Q4105 identifies the Integra dermal regeneration template product, including Omnigraft, supplied for wound coverage. The material is used in wound care, including burn treatment and, for Omnigraft, diabetic foot ulcer treatment. Plastic surgeons, wound-care clinicians, and podiatrists may use it in hospital outpatient departments, clinics, or other settings where a wound application procedure is performed. The product supply is distinct from the clinician’s work applying it.

Report Q4105 with the primary procedure used to apply the product, selecting that procedure for the wound’s site and treated area. Document the exact product, wound location and dimensions, amount supplied and applied, and the related application procedure. CMS classifies Q4105 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. CMS also classifies it as technical-component-only, with interpretation covered by a separate code.

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 Q4105 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

Q4105 rates by state

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

How the Q4105 rate is calculated

Each of Q4105’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.

Payment rules and modifiers for Q4105

The CMS indicators that decide how Q4105 is paid alongside other services.

Q4105 compared with similar codes

How to choose

Q4104Wound matrixIntegra BMWD

Q4104 identifies Integra BMWD, not Integra DRT or Omnigraft. Report the code that matches the product supplied.

Q4108Wound matrixIntegra Matrix

Q4108 identifies Integra Matrix. Q4105 is specific to Integra DRT or Omnigraft.

Q4101Skin substituteApligraf, per square centimeter

Q4101 identifies Apligraf, a different product. Use Q4105 only when the supplied product is Integra DRT or Omnigraft.

Codes related to Q4105

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

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

Open CMS sourceHow we calculate rates