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HCPCS code Q4238: Derm-Maxx, per square centimeter2026 Medicare rate & RVUs

Reports Derm-Maxx wound product by square centimeter when supplied with a primary wound procedure for application to a wound.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4238 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4238

Derm-Maxx, per square centimeter

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 Q4238 →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 Q4238 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 Q4238 covers

Q4238 identifies Derm-Maxx supplied for wound coverage and is measured in square-centimeter units. It represents the product, not the clinician’s work applying it. Wound-care clinicians and surgeons may use the product during treatment of a wound; the application procedure is reported separately. The product code is distinct from codes for other wound products, even when they are also measured by area.

Report Q4238 only with a primary procedure, using documentation that identifies Derm-Maxx and supports the quantity supplied or applied in square centimeters. CMS treats it as an add-on paid within the primary procedure’s global period, so it is not a stand-alone service. CMS classifies the code as technical-component-only; a separate code covers interpretation. The record should distinguish product quantity from the wound’s dimensions and identify the accompanying procedure.

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 Q4238 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

Q4238 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

Q4238 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
Q4238 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 Q4238 rate is calculated

Each of Q4238’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 · Q4238

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 Q4238

The CMS indicators that decide how Q4238 is paid alongside other services.

CMS payment indicators · Q4238

Derm-Maxx, per square centimeter

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.

Q4238 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • Q4238

    Derm-Maxx, per square centimeter0 wRVU

    $127.26

  • 15271

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

    $157.99+$30.73

  • 15275

    Skin substitute, face and other specified sites1.78 wRVU

    $160.32+$33.06

  • Q4239

    Amniotic graft, amnio-Maxx or Lite, per square centimeter0 wRVU

    $127.26+$0.00

How to choose

15271Skin substitute graftFirst 25 cm², trunk/limbs
15271 reports the wound application procedure for its specified body regions and initial treatment area. Q4238 reports the Derm-Maxx product by square centimeter and is billed with a primary procedure.
15275Skin substituteFace and other specified sites
15275 is the application procedure for the head, neck, hands, feet, or genitalia. Q4238 identifies the product used, not the application.
Q4239Amniotic graftAmnio-Maxx or Lite, per square centimeter
Q4239 identifies Amnio-Maxx or Lite, while Q4238 identifies Derm-Maxx. Use the code corresponding to the product documented.

Codes related to Q4238

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

Codes related to Q4238
CodeHow it relatesNational office range
Primary code
15271Skin substitute graft, first 25 cm², trunk/limbsPrimary wound application procedure for the specified body regions and initial treatment area.$140.17–$205.27
15275Skin substitute, face and other specified sitesPrimary wound application procedure for the head, neck, hands, feet, or genitalia.$143.80–$205.40
Used instead
Q4239Amniotic graft, amnio-Maxx or Lite, per square centimeterIdentifies Amnio-Maxx or Lite instead of Derm-Maxx when that is the product supplied.$109.31–$183.51

Q4238 billing questions

Does Q4238 report the product or its application?

It reports the Derm-Maxx product by square centimeter. Report the wound application procedure separately as the primary procedure.

Can Q4238 be billed by itself?

No. CMS identifies it as an add-on code that must be billed with a primary procedure and paid within that procedure’s global period.

How should the units be supported?

Document the product as Derm-Maxx and the quantity in square centimeters. The record should distinguish the amount supplied or applied from the wound’s measured dimensions.

Is an interpretation included in Q4238?

No. CMS classifies Q4238 as technical-component-only, with interpretation covered by a separate code.

How is Q4238 different from Q4239?

Q4238 identifies Derm-Maxx; Q4239 identifies Amnio-Maxx or Lite. Select the code matching the product documented, not merely the fact that both are reported by area.

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 Q4238PPRRVU2026_Oct_nonQPP.csv, line 18,327 (RVU26D)

Open CMS sourceHow we calculate rates

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