HCPCS code Q4133: Placental tissue product, grafix/Stravix Prime PL per square centimeter2026 Medicare rate & RVUs in Maine
Reports Grafix or Stravix Prime PL placental tissue by square centimeter when supplied for application to a treated wound.
Medicare pays $117.08–$126.11 for Q4133 in the office in Maine, from Rest of Maine to Southern Maine, ME. 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 Q4133 covers
Q4133 identifies Grafix or Stravix Prime PL, placental tissue products used as wound coverings in wound care. Clinicians such as podiatrists, surgeons, and wound-care practitioners may use these products when treating wounds including diabetic foot ulcers and venous leg ulcers. The code represents the product, not the work of assessing or preparing the wound or applying the tissue.
Report the product by the square centimeter and pair it with the applicable primary wound or skin-substitute application procedure. The record should identify the product used and support the quantity reported, such as the treated wound area and amount applied. CMS classifies Q4133 as an add-on paid within the primary procedure’s global period. It is also 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 Q4133 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $117.08 | Unavailable |
| Southern Maine, ME | $126.11 | Unavailable |
How the Q4133 rate is calculated
Each of Q4133’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 · Q4133
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 Q4133
The CMS indicators that decide how Q4133 is paid alongside other services.
CMS payment indicators · Q4133
Placental tissue product, grafix/Stravix Prime PL 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. |
Q4133 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4132Wound matrixGrafix Core or GrafixPL Core
- Use Q4132 for Grafix Core or GrafixPL Core. Q4133 is for Grafix or Stravix Prime PL; match the product name in the record.
- Q4121Skin substituteTheraSkin per square centimeter
- Q4121 identifies TheraSkin, not Grafix or Stravix Prime PL. These codes distinguish the product supplied, rather than the wound site.
- Q4124Wound matrixOasis tri-layer product
- Q4124 identifies Oasis tri-layer wound matrix. Use Q4133 when the documented product is Grafix or Stravix Prime PL.
Q4133 billing questions
How is Q4133 different from Q4132?
Q4133 identifies Grafix or Stravix Prime PL. Q4132 identifies Grafix Core or GrafixPL Core, so select the code that matches the product documented.
Can Q4133 be billed by itself?
No. CMS identifies it as an add-on code, so report it with a primary procedure. Payment is within that procedure’s global period.
How many units should be reported?
The code is reported per square centimeter. Document the product quantity used and the wound area treated to support the units.
Does Q4133 include the wound application procedure?
No. Q4133 identifies the product; report the applicable primary procedure for the wound or skin-substitute application separately.
What does the technical-component designation mean for Q4133?
CMS classifies Q4133 as technical-component-only, with a separate code covering interpretation.
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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