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HCPCS code Q4321: Renograft graft, per square centimeter2026 Medicare rate & RVUs in Nebraska

Q4321 reports Renograft by square centimeter when furnished with a primary wound procedure involving graft application.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Nebraska, Medicare pays $117.46 for Q4321 in the office.

$117.46Office (non-facility)
Not available in this settingHospital or facility
−7.7%vs the national office rate ($127.26)

Check a contract rate as a % of Medicare · Q4321 nationwide

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

We’ll open Q4321 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nebraska
  2. What Q4321 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What Q4321 covers

Q4321 identifies Renograft supplied by the square centimeter for use with a wound procedure. The product line is reported alongside the primary procedure that applies the graft; it is not a standalone service. The code is relevant to wound care encounters in which the documented product used is Renograft.

Report the quantity in square centimeters and retain documentation supporting the product used and the quantity furnished. CMS classifies Q4321 as an add-on code, so it must accompany a primary procedure and its payment is within that procedure’s global period. CMS also classifies it as technical-component-only; a separate code covers interpretation. The application procedure is selected separately according to the service performed and applicable site and area criteria.

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.

How Nebraska compares for Q4321

Across 109 of 109 payment localities, the office rate for Q4321 runs from $109.31 in Arkansas to $183.51 in Santa Clara County, CA. Nebraska pays $117.46. The RVUs are the same everywhere; the geographic indexes change the dollars.

Q4321 in Nebraska vs other payment areas
  1. Nebraska · this page$117.46
  2. Los Angeles, CA · California$150.55+$33.09
  3. Washington, DC area · District of Columbia$149.91+$32.45
  4. Miami, FL · Florida$132.47+$15.01
  5. Chicago, IL · Illinois$127.89+$10.43
  6. Manhattan, NY · New York$147.87+$30.41
  7. Alaska · Alaska$135.53+$18.07

Other areas in Nebraska first, then benchmark localities. Bars start at $0.

Every other payment area

Q4321 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$111.35—
ArkansasArkansas$109.31—
ArizonaArizona$123.31—
Bakersfield, CACalifornia$139.47—
Chico, CACalifornia$139.47—
El Centro, CACalifornia$139.47—
Fresno, CACalifornia$139.47—
Hanford, CACalifornia$139.47—

Q4321 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
Q4321 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

See Q4321 in every payment locality

How the Q4321 rate is calculated

Each of Q4321’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 · Q4321

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.

The exact Nebraska inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

18,408

Code
Q4321
Physician work
0.00
Practice expense
3.81
Malpractice
0.00

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office calculation for Q4321 in Nebraska
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense3.81× 0.9233.5166
Malpractice0.00× 0.3780.0000
Total RVUs3.5166
Conversion factor× 33.4009

Office rate, Nebraska$117.46

Office: (0 × 1 + 3.81 × 0.923 + 0 × 0.378) × $33.4009 = $117.46

Open Q4321 in the RVU calculator

Payment rules and modifiers for Q4321

The CMS indicators that decide how Q4321 is paid alongside other services.

CMS payment indicators · Q4321

Renograft graft, 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.

Codes related to Q4321

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

Codes related to Q4321
CodeHow it relatesOffice range, Nebraska
Primary code
15271Skin substitute graft, first 25 cm², trunk/limbsPrimary application procedure for grafts on qualifying trunk, arm, or leg sites.$145.75
15275Skin substitute, face and other specified sitesPrimary application procedure for grafts on qualifying head, neck, hand, foot, or genital sites.$148.92
Same family
Q4320Wound graft, pellograft, per square centimeterA separate per-square-centimeter product code for Pellograft.$117.46
Q4322Caregraft, per square centimeterA separate per-square-centimeter product code for Caregraft.$117.46

How Q4321 has changed in Nebraska

Q4321 · Office / nonfacility

$117.46

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    No ratechanged to$117.46

    Held through RVU26B, RVU26C, RVU26D.

  2. July 1, 2024

    RVU24C

    No ratechanged toNo rate

    Held through RVU24D, RVU25A, RVU25B, RVU25C, RVU25D.

  3. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$117.46Not available in this settingRVU26D
2026-07-01$117.46Not available in this settingRVU26C
2026-04-01$117.46Not available in this settingRVU26B
2026-01-01$117.46Not available in this settingRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Not in this releaseNot in this releaseRVU24B
2024-03-09Not in this releaseNot in this releaseRVU24AR
2024-01-01Not in this releaseNot in this releaseRVU24A
2023-10-01Not in this releaseNot in this releaseRVU23D
2023-07-01Not in this releaseNot in this releaseRVU23C
2023-04-01Not in this releaseNot in this releaseRVU23B
2023-01-01Not in this releaseNot in this releaseRVU23A
2022-10-01Not in this releaseNot in this releaseRVU22D
2022-07-01Not in this releaseNot in this releaseRVU22C
2022-04-01Not in this releaseNot in this releaseRVU22B
2022-01-01Not in this releaseNot in this releaseRVU22A
2021-10-01Not in this releaseNot in this releaseRVU21D
2021-07-01Not in this releaseNot in this releaseRVU21C
2021-04-01Not in this releaseNot in this releaseRVU21B
2021-01-01Not in this releaseNot in this releaseRVU21A
2020-10-01Not in this releaseNot in this releaseRVU20D
2020-07-01Not in this releaseNot in this releaseRVU20C
2020-04-01Not in this releaseNot in this releaseRVU20B
2020-01-01Not in this releaseNot in this releaseRVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price Q4321 for an earlier date of service

Where the Nebraska rate applies

Nebraska is a Medicare payment area, not a city. Our Census mapping connects it to 593 cities and communities in Nebraska. Some span more than one payment area; confirm with the service ZIP.

  • Abie
  • Adams
  • Agnew
  • Ainsworth
  • Albion
  • Alda
  • Alexandria
  • Allen

Browse all communities in Nebraska

Q4321 billing questions

Can Q4321 be reported by itself?

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

How is the Q4321 quantity reported?

The descriptor is per square centimeter. Document the Renograft quantity furnished in square centimeters.

Does Q4321 include interpretation?

No. CMS classifies Q4321 as technical-component-only; a separate code covers interpretation.

Which application code is paired with Q4321?

Pair it with the primary procedure that applies the graft. For example, the applicable wound-graft application code depends on the treated site and area.

What documentation supports Q4321?

Document that Renograft was used and the quantity furnished in square centimeters, along with the primary wound procedure.

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 Q4321PPRRVU2026_Oct_nonQPP.csv, line 18,408 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)

Open CMS sourceHow we calculate rates

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