HCPCS code Q4125: Dermal allograft, arthroFlex, per square centimeter2026 Medicare rate & RVUs in Maryland
Q4125 identifies ArthroFlex dermal allograft used to reinforce or reconstruct soft tissue, reported with a primary procedure and measured by area.
Medicare pays $128.78–$149.91 for Q4125 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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 Q4125 covers
Q4125 identifies ArthroFlex, a human acellular dermal matrix used as graft material in soft-tissue repair or reinforcement. Orthopedic surgeons commonly use dermal grafts in procedures such as rotator cuff repair; other reconstructive procedures may use them to reinforce or replace deficient soft tissue. The code represents the product, not the surgeon’s operative work, and is reported by the treating facility or clinician furnishing the material according to the applicable claim setting.
Report the quantity in square centimeters and retain documentation showing the product used and the area applied. CMS classifies Q4125 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. CMS also classifies it as technical-component-only; a separate code covers interpretation. CMS assigns no physician work RVUs to Q4125, so the code represents the technical side rather than professional 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 Q4125 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$128.78 to $149.91
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $136.55 | Unavailable |
| Rest of Maryland | $128.78 | Unavailable |
| Washington, DC area | $149.91 | Unavailable |
How the Q4125 rate is calculated
Each of Q4125’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 · Q4125
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 Q4125
The CMS indicators that decide how Q4125 is paid alongside other services.
CMS payment indicators · Q4125
Dermal allograft, arthroFlex, 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. |
Q4125 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4128Skin matrixFlexHD or AlloPatch HD
- Q4128 identifies FlexHD and related products; Q4125 identifies ArthroFlex. Select the code matching the product furnished.
- Q4116Dermal matrixAlloDerm per square centimeter
- Q4116 is the product-specific code for AlloDerm. It is not the code for ArthroFlex, even when both are used as dermal matrices.
- Q4122Wound matrixDermACELL AWM, per sq cm
- Q4122 identifies DermACELL AWM, while Q4125 identifies ArthroFlex. The product record determines which code applies.
Q4125 billing questions
Can Q4125 be billed by itself?
No. CMS identifies Q4125 as an add-on code that must be reported with a primary procedure.
How should the quantity be reported?
Report the ArthroFlex material by square centimeter. Documentation should support the product used and the area applied.
Does Q4125 include the surgeon’s work?
No. The code identifies the graft material. CMS classifies it as technical-component-only, with interpretation covered by a separate code.
How does the global-period rule affect Q4125?
CMS places payment for this add-on within the primary procedure’s global period. Report Q4125 with that primary procedure, not as a standalone service.
Is Q4125 interchangeable with other dermal matrix codes?
No. Q4125 identifies ArthroFlex specifically. Other graft products have their own HCPCS codes and should not be substituted based only on a general similarity in material or use.
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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