HCPCS code Q4105: Skin substitute, integra DRT or Omnigraft2026 Medicare rate & RVUs in Arkansas
Reports Integra DRT or Omnigraft wound matrix supplied for application to a wound, such as a burn or diabetic foot ulcer.
In Arkansas, Medicare pays $109.31 for Q4105 in the office.
Check a contract rate as a % of Medicare · Q4105 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Arkansas compares for Q4105
Across 109 of 109 payment localities, the office rate for Q4105 runs from $109.31 in Arkansas to $183.51 in Santa Clara County, CA. Arkansas pays $109.31. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arkansas · this page$109.31
- Los Angeles, CA · California$150.55+$41.24
- Washington, DC area · District of Columbia$149.91+$40.60
- Miami, FL · Florida$132.47+$23.16
- Chicago, IL · Illinois$127.89+$18.58
- Manhattan, NY · New York$147.87+$38.56
- Alaska · Alaska$135.53+$26.22
Other areas in Arkansas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $111.35 | — |
| ArizonaArizona | $123.31 | — |
| Bakersfield, CACalifornia | $139.47 | — |
| Chico, CACalifornia | $139.47 | — |
| El Centro, CACalifornia | $139.47 | — |
| Fresno, CACalifornia | $139.47 | — |
| Hanford, CACalifornia | $139.47 | — |
| Madera, CACalifornia | $139.47 | — |
| Merced, CACalifornia | $139.47 | — |
| Modesto, CACalifornia | $139.47 | — |
| Napa, CACalifornia | $167.73 | — |
| Oxnard, CACalifornia | $150.42 | — |
| Redding, CACalifornia | $139.47 | — |
| Rest of CaliforniaCalifornia | $139.47 | — |
| Riverside, CACalifornia | $139.47 | — |
| Sacramento, CACalifornia | $148.00 | — |
| Salinas, CACalifornia | $147.49 | — |
| San Diego, CACalifornia | $152.20 | — |
| Marin County, CACalifornia | $179.43 | — |
| San Francisco, CACalifornia | $179.43 | — |
| San Benito County, CACalifornia | $183.51 | — |
| Santa Clara County, CACalifornia | $183.51 | — |
| San Luis Obispo, CACalifornia | $144.95 | — |
| Santa Cruz, CACalifornia | $154.62 | — |
| Santa Maria, CACalifornia | $148.38 | — |
| Santa Rosa, CACalifornia | $156.27 | — |
| Stockton, CACalifornia | $139.47 | — |
| Vallejo, CACalifornia | $167.73 | — |
| Visalia, CACalifornia | $139.47 | — |
| Yuba City, CACalifornia | $139.47 | — |
| ColoradoColorado | $135.40 | — |
| ConnecticutConnecticut | $137.06 | — |
| DelawareDelaware | $125.73 | — |
| Fort Lauderdale, FLFlorida | $128.91 | — |
| Rest of FloridaFlorida | $121.66 | — |
| Atlanta, GAGeorgia | $129.29 | — |
| Rest of GeorgiaGeorgia | $113.51 | — |
| Hawaii, Guam, HIHawaii | $144.69 | — |
| IowaIowa | $116.44 | — |
| IdahoIdaho | $117.08 | — |
| East St. Louis, ILIllinois | $117.08 | — |
| Rest of IllinoisIllinois | $116.19 | — |
| Suburban Chicago, ILIllinois | $130.69 | — |
| IndianaIndiana | $117.97 | — |
| KansasKansas | $115.04 | — |
| KentuckyKentucky | $113.13 | — |
| New Orleans, LALouisiana | $119.75 | — |
| Rest of LouisianaLouisiana | $112.62 | — |
| Metropolitan Boston, MAMassachusetts | $151.95 | — |
| Rest of MassachusettsMassachusetts | $134.00 | — |
| Baltimore area, MDMaryland | $136.55 | — |
| Rest of MarylandMaryland | $128.78 | — |
| Rest of MaineMaine | $117.08 | — |
| Southern Maine, MEMaine | $126.11 | — |
| Detroit, MIMichigan | $122.80 | — |
| Rest of MichiganMichigan | $116.19 | — |
| MinnesotaMinnesota | $130.95 | — |
| Metropolitan Kansas City, MOMissouri | $119.49 | — |
| Metropolitan St. Louis, MOMissouri | $121.15 | — |
| Rest of MissouriMissouri | $109.70 | — |
| MississippiMississippi | $109.57 | — |
| MontanaMontana | $127.26 | — |
| North CarolinaNorth Carolina | $118.73 | — |
| North DakotaNorth Dakota | $127.26 | — |
| NebraskaNebraska | $117.46 | — |
| New HampshireNew Hampshire | $132.47 | — |
| Northern New JerseyNew Jersey | $147.62 | — |
| Rest of New JerseyNew Jersey | $138.97 | — |
| New MexicoNew Mexico | $116.70 | — |
| NevadaNevada | $127.38 | — |
| NYC suburbs and Long Island, NYNew York | $151.31 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $139.35 | — |
| Queens, NYNew York | $150.42 | — |
| Rest of New YorkNew York | $120.89 | — |
| OhioOhio | $116.19 | — |
| OklahomaOklahoma | $113.64 | — |
| Portland, OROregon | $141.38 | — |
| Rest of OregonOregon | $126.75 | — |
| Metropolitan Philadelphia, PAPennsylvania | $132.47 | — |
| Rest of PennsylvaniaPennsylvania | $116.82 | — |
| Puerto RicoPuerto Rico | $128.66 | — |
| Rhode IslandRhode Island | $131.46 | — |
| South CarolinaSouth Carolina | $117.59 | — |
| South DakotaSouth Dakota | $127.26 | — |
| TennesseeTennessee | $115.68 | — |
| Austin, TXTexas | $134.64 | — |
| Beaumont, TXTexas | $115.80 | — |
| Brazoria, TXTexas | $126.11 | — |
| Dallas, TXTexas | $126.75 | — |
| Fort Worth, TXTexas | $125.48 | — |
| Galveston, TXTexas | $126.37 | — |
| Houston, TXTexas | $126.37 | — |
| Rest of TexasTexas | $120.77 | — |
| UtahUtah | $119.62 | — |
| VirginiaVirginia | $125.09 | — |
| Virgin Islands, VIUnited States Virgin Islands | $128.66 | — |
| VermontVermont | $125.98 | — |
| Rest of WashingtonWashington | $134.00 | — |
| King County, WAWashington | $156.14 | — |
| WisconsinWisconsin | $121.91 | — |
| West VirginiaWest Virginia | $110.59 | — |
| WyomingWyoming | $127.26 | — |
Q4105 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $135.53 | 1 |
| AL | $111.35 | 1 |
| AR | $109.31 | 1 |
| AZ | $123.31 | 1 |
| CA | $139.47–$183.51 | 29 |
| CO | $135.40 | 1 |
| CT | $137.06 | 1 |
| DC | $149.91 | 1 |
| DE | $125.73 | 1 |
| FL | $121.66–$132.47 | 3 |
| GA | $113.51–$129.29 | 2 |
| GU | $144.69 | 1 |
| HI | $144.69 | 1 |
| IA | $116.44 | 1 |
| ID | $117.08 | 1 |
| IL | $116.19–$130.69 | 4 |
| IN | $117.97 | 1 |
| KS | $115.04 | 1 |
| KY | $113.13 | 1 |
| LA | $112.62–$119.75 | 2 |
| MA | $134.00–$151.95 | 2 |
| MD | $128.78–$149.91 | 3 |
| ME | $117.08–$126.11 | 2 |
| MI | $116.19–$122.80 | 2 |
| MN | $130.95 | 1 |
| MO | $109.70–$121.15 | 3 |
| MS | $109.57 | 1 |
| MT | $127.26 | 1 |
| NC | $118.73 | 1 |
| ND | $127.26 | 1 |
| NE | $117.46 | 1 |
| NH | $132.47 | 1 |
| NJ | $138.97–$147.62 | 2 |
| NM | $116.70 | 1 |
| NV | $127.38 | 1 |
| NY | $120.89–$151.31 | 5 |
| OH | $116.19 | 1 |
| OK | $113.64 | 1 |
| OR | $126.75–$141.38 | 2 |
| PA | $116.82–$132.47 | 2 |
| PR | $128.66 | 1 |
| RI | $131.46 | 1 |
| SC | $117.59 | 1 |
| SD | $127.26 | 1 |
| TN | $115.68 | 1 |
| TX | $115.80–$134.64 | 8 |
| UT | $119.62 | 1 |
| VA | $125.09–$149.91 | 2 |
| VI | $128.66 | 1 |
| VT | $125.98 | 1 |
| WA | $134.00–$156.14 | 2 |
| WI | $121.91 | 1 |
| WV | $110.59 | 1 |
| WY | $127.26 | 1 |
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.
How the rate is built · Q4105
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.
The exact Arkansas inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
18,205
- Code
- Q4105
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.859 | 3.2728 |
| Malpractice | 0.00 | × 0.515 | 0.0000 |
| Total RVUs | 3.2728 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Arkansas$109.31
Office: (0 × 1 + 3.81 × 0.859 + 0 × 0.515) × $33.4009 = $109.31
Payment rules and modifiers for Q4105
The CMS indicators that decide how Q4105 is paid alongside other services.
CMS payment indicators · Q4105
Skin substitute, integra DRT or Omnigraft
| 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. |
How Q4105 has changed in Arkansas
Q4105 · Office / nonfacility
$109.31
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.
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
January 1, 2026
RVU26A
No ratechanged to$109.31
Held through RVU26B, RVU26C, RVU26D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $109.31 | Not available in this setting | RVU26D |
| 2026-07-01 | $109.31 | Not available in this setting | RVU26C |
| 2026-04-01 | $109.31 | Not available in this setting | RVU26B |
| 2026-01-01 | $109.31 | Not available in this setting | RVU26A |
| 2025-10-01 | Separate payment rules apply | Separate payment rules apply | RVU25D |
| 2025-07-01 | Separate payment rules apply | Separate payment rules apply | RVU25C |
| 2025-04-01 | Separate payment rules apply | Separate payment rules apply | RVU25B |
| 2025-01-01 | Separate payment rules apply | Separate payment rules apply | RVU25A |
| 2024-10-01 | Separate payment rules apply | Separate payment rules apply | RVU24D |
| 2024-07-01 | Separate payment rules apply | Separate payment rules apply | RVU24C |
| 2024-04-01 | Separate payment rules apply | Separate payment rules apply | RVU24B |
| 2024-03-09 | Separate payment rules apply | Separate payment rules apply | RVU24AR |
| 2024-01-01 | Separate payment rules apply | Separate payment rules apply | RVU24A |
| 2023-10-01 | Separate payment rules apply | Separate payment rules apply | RVU23D |
| 2023-07-01 | Separate payment rules apply | Separate payment rules apply | RVU23C |
| 2023-04-01 | Separate payment rules apply | Separate payment rules apply | RVU23B |
| 2023-01-01 | Separate payment rules apply | Separate payment rules apply | RVU23A |
| 2022-10-01 | Separate payment rules apply | Separate payment rules apply | RVU22D |
| 2022-07-01 | Separate payment rules apply | Separate payment rules apply | RVU22C |
| 2022-04-01 | Separate payment rules apply | Separate payment rules apply | RVU22B |
| 2022-01-01 | Separate payment rules apply | Separate payment rules apply | RVU22A |
| 2021-10-01 | Separate payment rules apply | Separate payment rules apply | RVU21D |
| 2021-07-01 | Separate payment rules apply | Separate payment rules apply | RVU21C |
| 2021-04-01 | Separate payment rules apply | Separate payment rules apply | RVU21B |
| 2021-01-01 | Separate payment rules apply | Separate payment rules apply | RVU21A |
| 2020-10-01 | Separate payment rules apply | Separate payment rules apply | RVU20D |
| 2020-07-01 | Separate payment rules apply | Separate payment rules apply | RVU20C |
| 2020-04-01 | Separate payment rules apply | Separate payment rules apply | RVU20B |
| 2020-01-01 | Separate payment rules apply | Separate payment rules apply | RVU20A |
| 2019-10-01 | Separate payment rules apply | Separate payment rules apply | RVU19D |
| 2019-07-01 | Separate payment rules apply | Separate payment rules apply | RVU19C |
| 2019-04-01 | Separate payment rules apply | Separate payment rules apply | RVU19B |
| 2019-01-01 | Separate payment rules apply | Separate payment rules apply | RVU19A |
| 2018-10-01 | Separate payment rules apply | Separate payment rules apply | RVU18D |
| 2018-07-01 | Separate payment rules apply | Separate payment rules apply | RVU18C |
| 2018-04-01 | Separate payment rules apply | Separate payment rules apply | RVU18B |
| 2018-01-01 | Separate payment rules apply | Separate payment rules apply | RVU18AR1 |
| 2017-10-01 | Separate payment rules apply | Separate payment rules apply | RVU17D |
| 2017-07-01 | Separate payment rules apply | Separate payment rules apply | RVU17C |
| 2017-04-01 | Separate payment rules apply | Separate payment rules apply | RVU17B |
| 2017-01-01 | Separate payment rules apply | Separate payment rules apply | RVU17A |
| 2016-10-01 | Separate payment rules apply | Separate payment rules apply | RVU16D |
| 2016-07-01 | Separate payment rules apply | Separate payment rules apply | RVU16C |
| 2016-04-01 | Separate payment rules apply | Separate payment rules apply | RVU16B |
| 2016-01-01 | Separate payment rules apply | Separate payment rules apply | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Separate payment rules apply | Separate payment rules apply | RVU14D |
| 2014-07-01 | Separate payment rules apply | Separate payment rules apply | RVU14C |
| 2014-04-01 | Separate payment rules apply | Separate payment rules apply | RVU14B |
| 2014-01-01 | Separate payment rules apply | Separate payment rules apply | RVU14A |
| 2013-10-01 | Separate payment rules apply | Separate payment rules apply | RVU13D |
| 2013-07-01 | Separate payment rules apply | Separate payment rules apply | RVU13C |
| 2013-04-01 | Separate payment rules apply | Separate payment rules apply | RVU13B |
| 2013-01-01 | Separate payment rules apply | Separate payment rules apply | RVU13AR |
Where the Arkansas rate applies
Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.
- Acorn
- Adona
- Alexander
- Alicia
- Alix
- Alleene
- Allport
- Alma
Q4105 billing questions
How is Q4105 different from the Integra product codes Q4104 and Q4108?
Q4105 identifies Integra DRT or Omnigraft. Q4104 and Q4108 identify different Integra products, so verify the product actually supplied rather than choosing by manufacturer alone.
Can Q4105 be billed by itself?
No. CMS identifies it as an add-on code, so report it with the primary procedure used to apply the product.
Which application code should accompany Q4105?
Choose the primary wound-application procedure according to the wound site and treated area. For example, the application-code family includes 15271 for trunk, arm, or leg sites and 15275 for sites such as the feet.
What should the record support?
Document the exact Integra product, wound site and dimensions, amount supplied and applied, and the application procedure. The documentation should make clear that Q4105 represents the product rather than the application work.
How does the global-period rule affect Q4105?
Q4105 is billed with its primary procedure and paid within that procedure’s global period. It is not a stand-alone service line.
Does Q4105 include interpretation?
CMS classifies Q4105 as technical-component-only and assigns interpretation to a separate code. Q4105 itself identifies the product supply.
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
Fee sheets · Coming soon
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