HCPCS code Q4323: AlloPly, per square centimeter2026 Medicare rate & RVUs in New York
Reports the square-centimeter quantity of AlloPly furnished for wound treatment, alongside the primary procedure used to apply the graft.
Medicare pays $120.89–$151.31 for Q4323 in the office in New York, from Rest of New York to NYC suburbs and Long Island, NY. 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 Q4323 covers
Q4323 identifies the AlloPly wound-care graft product by the area supplied, rather than the clinician’s work to prepare or treat the wound. It may be used in outpatient wound care, including treatment of chronic diabetic foot or venous leg ulcers when the clinician selects this product. The clinician performing the application may be a physician or another qualified practitioner, depending on the setting and applicable coverage rules.
Report Q4323 with the primary skin-substitute application procedure, selecting that procedure by the wound site and treated area. Units should reflect the square-centimeter quantity represented by the product documentation and claim. The record should identify AlloPly, the wound treated, and the amount used. CMS treats Q4323 as an add-on paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation. Its PFS valuation has no physician work or malpractice RVUs.
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 Q4323 pays more and less in New York
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
5 payment localities
$120.89 to $151.31
| Payment locality | Office | Facility |
|---|---|---|
| Manhattan, NY | $147.87 | Unavailable |
| NYC suburbs and Long Island, NY | $151.31 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $139.35 | Unavailable |
| Queens, NY | $150.42 | Unavailable |
| Rest of New York | $120.89 | Unavailable |
How the Q4323 rate is calculated
Each of Q4323’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 · Q4323
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 Q4323
The CMS indicators that decide how Q4323 is paid alongside other services.
CMS payment indicators · Q4323
AlloPly, 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. |
Q4323 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 graft-application service for qualifying trunk, arm, or leg wounds; Q4323 identifies the AlloPly product by area. Report both when the product and application service are furnished.
- Q4322CaregraftPer square centimeter
- Q4322 identifies Caregraft, not AlloPly. Select the product code from the graft actually furnished.
- Q4324Amniotic graftAmnioTx, per square centimeter
- Q4324 identifies Amniotx, not AlloPly. These product-specific codes are not selected by wound site or area.
Q4323 billing questions
What procedure should be reported with Q4323?
Report it with the primary procedure for applying the skin substitute graft. Choose the application code based on the wound site and treated area.
How are units determined?
The descriptor is per square centimeter, so the claim quantity should reflect the documented AlloPly area represented. Keep product and wound-area records that support the quantity billed.
Can Q4323 be reported by itself?
No. CMS identifies Q4323 as an add-on code that must be billed with a primary procedure.
Does Q4323 include the graft application work?
Q4323 identifies the AlloPly product, while the primary application procedure reports the graft-placement service. CMS places payment for Q4323 within that procedure’s global period.
How does the technical-component designation affect billing?
CMS classifies Q4323 as technical-component-only, with a separate code covering interpretation. The product line itself does not report the interpretation.
How is Q4323 distinguished from Q4322 or Q4324?
Those codes identify different named wound-care products. Report the HCPCS code matching the product actually furnished, rather than choosing among them by wound size.
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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