HCPCS code Q4238: Derm-Maxx, per square centimeter2026 Medicare rate & RVUs in Texas
Reports Derm-Maxx wound product by square centimeter when supplied with a primary wound procedure for application to a wound.
Medicare pays $115.80–$134.64 for Q4238 in the office in Texas, from Beaumont, TX to Austin, TX. 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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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$115.80 to $134.64
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $134.64 | Unavailable |
| Beaumont, TX | $115.80 | Unavailable |
| Brazoria, TX | $126.11 | Unavailable |
| Dallas, TX | $126.75 | Unavailable |
| Fort Worth, TX | $125.48 | Unavailable |
| Galveston, TX | $126.37 | Unavailable |
| Houston, TX | $126.37 | Unavailable |
| Rest of Texas | $120.77 | Unavailable |
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
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
| 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. |
Q4238 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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