HCPCS code Q4274: Wound graft, esano AC, per square centimeter2026 Medicare rate & RVUs
Reports Esano AC wound-graft material by square centimeter when the product is furnished for application during a wound procedure.
Medicare pays $127.26 for Q4274 nationally in the office. Local office rates run $109.31–$183.51.
Medicare rate · Q4274
Wound graft, esano AC, per square centimeter
- Work RVUs
- 0
- Total RVUs
- 3.81
- Global days
- ZZZ
National rate · 2026
$127.26
Office setting, before claim adjustments.
See every locality for Q4274 →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.
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On this page 10 sections
What Q4274 covers
Q4274 identifies the Esano AC product supplied for wound coverage. A clinician may apply it to a wound as part of a skin-substitute procedure, such as treatment of a chronic ulcer. This code represents the product quantity, not the clinician’s wound preparation or application service. The application procedure is reported separately according to the site and area treated.
Report the units from the documented square centimeters of Esano AC furnished for the procedure, and retain the product record and wound-area documentation to support the quantity. Q4274 is an add-on code and must be reported with a primary procedure; its payment is within that procedure’s global period. CMS classifies it as technical-component-only, with a separate code covering 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 Q4274 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 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $111.35 | Unavailable |
| Alaska | $135.53 | Unavailable |
| Arizona | $123.31 | Unavailable |
| Arkansas | $109.31 | Unavailable |
| Atlanta, GA | $129.29 | Unavailable |
| Austin, TX | $134.64 | Unavailable |
| Bakersfield, CA | $139.47 | Unavailable |
| Baltimore area, MD | $136.55 | Unavailable |
| Beaumont, TX | $115.80 | Unavailable |
| Brazoria, TX | $126.11 | Unavailable |
| Chicago, IL | $127.89 | Unavailable |
| Chico, CA | $139.47 | Unavailable |
| Colorado | $135.40 | Unavailable |
| Connecticut | $137.06 | Unavailable |
| Dallas, TX | $126.75 | Unavailable |
| Delaware | $125.73 | Unavailable |
| Detroit, MI | $122.80 | Unavailable |
| East St. Louis, IL | $117.08 | Unavailable |
| El Centro, CA | $139.47 | Unavailable |
| Fort Lauderdale, FL | $128.91 | Unavailable |
| Fort Worth, TX | $125.48 | Unavailable |
| Fresno, CA | $139.47 | Unavailable |
| Galveston, TX | $126.37 | Unavailable |
| Hanford, CA | $139.47 | Unavailable |
| Hawaii, Guam, HI | $144.69 | Unavailable |
| Houston, TX | $126.37 | Unavailable |
| Idaho | $117.08 | Unavailable |
| Indiana | $117.97 | Unavailable |
| Iowa | $116.44 | Unavailable |
| Kansas | $115.04 | Unavailable |
| Kentucky | $113.13 | Unavailable |
| King County, WA | $156.14 | Unavailable |
| Los Angeles, CA | $150.55 | Unavailable |
| Madera, CA | $139.47 | Unavailable |
| Manhattan, NY | $147.87 | Unavailable |
| Marin County, CA | $179.43 | Unavailable |
| Merced, CA | $139.47 | Unavailable |
| Metropolitan Boston, MA | $151.95 | Unavailable |
| Metropolitan Kansas City, MO | $119.49 | Unavailable |
| Metropolitan Philadelphia, PA | $132.47 | Unavailable |
| Metropolitan St. Louis, MO | $121.15 | Unavailable |
| Miami, FL | $132.47 | Unavailable |
| Minnesota | $130.95 | Unavailable |
| Mississippi | $109.57 | Unavailable |
| Modesto, CA | $139.47 | Unavailable |
| Montana | $127.26 | Unavailable |
| Napa, CA | $167.73 | Unavailable |
| Nebraska | $117.46 | Unavailable |
| Nevada | $127.38 | Unavailable |
| New Hampshire | $132.47 | Unavailable |
| New Mexico | $116.70 | Unavailable |
| New Orleans, LA | $119.75 | Unavailable |
| North Carolina | $118.73 | Unavailable |
| North Dakota | $127.26 | Unavailable |
| Northern New Jersey | $147.62 | Unavailable |
| NYC suburbs and Long Island, NY | $151.31 | Unavailable |
| Ohio | $116.19 | Unavailable |
| Oklahoma | $113.64 | Unavailable |
| Oxnard, CA | $150.42 | Unavailable |
| Portland, OR | $141.38 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $139.35 | Unavailable |
| Puerto Rico | $128.66 | Unavailable |
| Queens, NY | $150.42 | Unavailable |
| Redding, CA | $139.47 | Unavailable |
| Rest of California | $139.47 | Unavailable |
| Rest of Florida | $121.66 | Unavailable |
| Rest of Georgia | $113.51 | Unavailable |
| Rest of Illinois | $116.19 | Unavailable |
| Rest of Louisiana | $112.62 | Unavailable |
| Rest of Maine | $117.08 | Unavailable |
| Rest of Maryland | $128.78 | Unavailable |
| Rest of Massachusetts | $134.00 | Unavailable |
| Rest of Michigan | $116.19 | Unavailable |
| Rest of Missouri | $109.70 | Unavailable |
| Rest of New Jersey | $138.97 | Unavailable |
| Rest of New York | $120.89 | Unavailable |
| Rest of Oregon | $126.75 | Unavailable |
| Rest of Pennsylvania | $116.82 | Unavailable |
| Rest of Texas | $120.77 | Unavailable |
| Rest of Washington | $134.00 | Unavailable |
| Rhode Island | $131.46 | Unavailable |
| Riverside, CA | $139.47 | Unavailable |
| Sacramento, CA | $148.00 | Unavailable |
| Salinas, CA | $147.49 | Unavailable |
| San Benito County, CA | $183.51 | Unavailable |
| San Diego, CA | $152.20 | Unavailable |
| San Francisco, CA | $179.43 | Unavailable |
| San Luis Obispo, CA | $144.95 | Unavailable |
| Santa Clara County, CA | $183.51 | Unavailable |
| Santa Cruz, CA | $154.62 | Unavailable |
| Santa Maria, CA | $148.38 | Unavailable |
| Santa Rosa, CA | $156.27 | Unavailable |
| South Carolina | $117.59 | Unavailable |
| South Dakota | $127.26 | Unavailable |
| Southern Maine, ME | $126.11 | Unavailable |
| Stockton, CA | $139.47 | Unavailable |
| Suburban Chicago, IL | $130.69 | Unavailable |
| Tennessee | $115.68 | Unavailable |
| Utah | $119.62 | Unavailable |
| Vallejo, CA | $167.73 | Unavailable |
| Vermont | $125.98 | Unavailable |
| Virgin Islands, VI | $128.66 | Unavailable |
| Virginia | $125.09 | Unavailable |
| Visalia, CA | $139.47 | Unavailable |
| Washington, DC area | $149.91 | Unavailable |
| West Virginia | $110.59 | Unavailable |
| Wisconsin | $121.91 | Unavailable |
| Wyoming | $127.26 | Unavailable |
| Yuba City, CA | $139.47 | Unavailable |
Q4274 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $135.53 | 1 |
| AL | $111.35 | 1 |
| AR | $109.31 | 1 |
| AZ | $123.31 | 1 |
| CA | $139.47–$183.51 | 29 |
| CO | $135.40 | 1 |
| CT | $137.06 | 1 |
| DC | $149.91 | 1 |
| DE | $125.73 | 1 |
| FL | $121.66–$132.47 | 3 |
| GA | $113.51–$129.29 | 2 |
| GU | $144.69 | 1 |
| HI | $144.69 | 1 |
| IA | $116.44 | 1 |
| ID | $117.08 | 1 |
| IL | $116.19–$130.69 | 4 |
| IN | $117.97 | 1 |
| KS | $115.04 | 1 |
| KY | $113.13 | 1 |
| LA | $112.62–$119.75 | 2 |
| MA | $134.00–$151.95 | 2 |
| MD | $128.78–$149.91 | 3 |
| ME | $117.08–$126.11 | 2 |
| MI | $116.19–$122.80 | 2 |
| MN | $130.95 | 1 |
| MO | $109.70–$121.15 | 3 |
| MS | $109.57 | 1 |
| MT | $127.26 | 1 |
| NC | $118.73 | 1 |
| ND | $127.26 | 1 |
| NE | $117.46 | 1 |
| NH | $132.47 | 1 |
| NJ | $138.97–$147.62 | 2 |
| NM | $116.70 | 1 |
| NV | $127.38 | 1 |
| NY | $120.89–$151.31 | 5 |
| OH | $116.19 | 1 |
| OK | $113.64 | 1 |
| OR | $126.75–$141.38 | 2 |
| PA | $116.82–$132.47 | 2 |
| PR | $128.66 | 1 |
| RI | $131.46 | 1 |
| SC | $117.59 | 1 |
| SD | $127.26 | 1 |
| TN | $115.68 | 1 |
| TX | $115.80–$134.64 | 8 |
| UT | $119.62 | 1 |
| VA | $125.09–$149.91 | 2 |
| VI | $128.66 | 1 |
| VT | $125.98 | 1 |
| WA | $134.00–$156.14 | 2 |
| WI | $121.91 | 1 |
| WV | $110.59 | 1 |
| WY | $127.26 | 1 |
How the Q4274 rate is calculated
Each of Q4274’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 · Q4274
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 Q4274
The CMS indicators that decide how Q4274 is paid alongside other services.
CMS payment indicators · Q4274
Wound graft, esano AC, 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. |
Q4274 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4272Esano APer square centimeter
- Q4272 identifies Esano A; Q4274 identifies Esano AC. Select the code that matches the product supplied, not the wound size.
- Q4273Esano AAAPer square centimeter
- Q4273 identifies Esano AAA, while Q4274 identifies Esano AC. These product-specific codes are not interchangeable.
- Q4275Esano ACAPer square centimeter
- Q4275 identifies Esano ACA; Q4274 identifies Esano AC. Use the product identifier for the material furnished.
Q4274 billing questions
How is Q4274 different from the other Esano codes?
Q4274 identifies Esano AC. Q4272, Q4273, and Q4275 identify other Esano product variants; report the code matching the product actually furnished.
Is Q4274 reported by wound or by square centimeter?
It is reported by square centimeter. The documented quantity should support the units billed.
Can Q4274 be billed without a wound application procedure?
No. It is an add-on code and must be reported with a primary procedure; payment is within that procedure’s global period.
Does Q4274 include the wound application service?
No. Q4274 identifies the Esano AC product. Report the applicable wound application procedure separately.
What documentation supports the Q4274 units?
Document that Esano AC was furnished and the square-centimeter quantity used. The wound record should support the treated area and the product quantity.
How does CMS classify the code’s components?
CMS classifies Q4274 as technical-component-only; a separate code covers 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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