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HCPCS code Q4128: Skin matrix, flexHD or AlloPatch HD2026 Medicare rate & RVUs

Reports FlexHD or AlloPatch HD biologic matrix by square centimeter when supplied for a skin-substitute application procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4128 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4128

Skin matrix, flexHD or AlloPatch HD

Office or facility?

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4128 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What Q4128 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What Q4128 covers

Q4128 identifies FlexHD or AlloPatch HD, human-derived biologic matrices used as skin substitutes to cover a wound or support tissue repair. The product may be supplied for wound-care or surgical treatment, with the clinician selecting and applying it to the prepared site. The code represents the named product, not the work of preparing the wound or applying the matrix.

Report Q4128 with the primary procedure for the skin-substitute application, not as a stand-alone service. Units are based on the documented square centimeters of product reported; the record should identify the product, wound site, and amount used. CMS treats this as an add-on code, so payment falls within the primary procedure's global period. CMS classifies it 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.

Where Q4128 pays more and less

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

109 payment localities

$109.31 to $183.51

$109.31$146.41$183.51
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

Q4128 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$111.35Unavailable
Alaska$135.53Unavailable
Arizona$123.31Unavailable
Arkansas$109.31Unavailable
Atlanta, GA$129.29Unavailable
Austin, TX$134.64Unavailable
Bakersfield, CA$139.47Unavailable
Baltimore area, MD$136.55Unavailable
Beaumont, TX$115.80Unavailable
Brazoria, TX$126.11Unavailable

Q4128 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
Q4128 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

How the Q4128 rate is calculated

Each of Q4128’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 · Q4128

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.

Payment rules and modifiers for Q4128

The CMS indicators that decide how Q4128 is paid alongside other services.

CMS payment indicators · Q4128

Skin matrix, flexHD or AlloPatch HD

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.

Q4128 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • Q4128

    Skin matrix, flexHD or AlloPatch HD0 wRVU

    $127.26

  • 15271

    Skin substitute graft, first 25 cm², trunk/limbs1.46 wRVU

    $157.99+$30.73

  • Q4121

    Skin substitute, theraSkin per square centimeter0 wRVU

    $127.26+$0.00

  • Q4122

    Wound matrix, dermACELL AWM, per sq cm0 wRVU

    $127.26+$0.00

How to choose

15271Skin substitute graftFirst 25 cm², trunk/limbs
15271 reports the application procedure for a qualifying wound at its specified anatomic sites; Q4128 identifies the FlexHD or AlloPatch HD product used with a primary application procedure.
Q4121Skin substituteTheraSkin per square centimeter
Q4121 identifies TheraSkin. Choose the product code that matches the specific skin substitute supplied; it is not interchangeable with Q4128.
Q4122Wound matrixDermACELL AWM, per sq cm
Q4122 identifies DermACELL AWM. Q4128 is specific to FlexHD or AlloPatch HD, even when the products serve a similar treatment purpose.

Codes related to Q4128

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

Codes related to Q4128
CodeHow it relatesNational office range
Primary code
15271Skin substitute graft, first 25 cm², trunk/limbsA primary skin-substitute application procedure for qualifying wounds on the trunk, arms, or legs.$140.17–$205.27
15275Skin substitute, face and other specified sitesA primary skin-substitute application procedure for qualifying wounds at other specified anatomic sites.$143.80–$205.40
Used instead
Q4121Skin substitute, theraSkin per square centimeterTheraSkin is a different skin-substitute product reported under its own HCPCS code.$109.31–$183.51
Q4122Wound matrix, dermACELL AWM, per sq cmDermACELL AWM is a different skin-substitute product reported under its own HCPCS code.$109.31–$183.51

Q4128 billing questions

Is Q4128 the application procedure?

No. Q4128 identifies the FlexHD or AlloPatch HD product. Report the applicable skin-substitute application procedure separately as the primary service.

Can Q4128 be billed by itself?

No. CMS identifies it as an add-on code that must be billed with a primary procedure.

How are units determined?

Report the product quantity in square centimeters and document the product and wound site. The code descriptor identifies the unit as one square centimeter.

How does the global-period rule affect payment?

Payment for Q4128 is included within the global period of the primary procedure. It is not paid as a separate stand-alone service outside that procedure.

Does Q4128 include interpretation?

No. CMS classifies Q4128 as technical-component-only, with interpretation covered by a separate code.

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 Q4128PPRRVU2026_Oct_nonQPP.csv, line 18,224 (RVU26D)

Open CMS sourceHow we calculate rates

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