HCPCS code Q4357: Wound matrix, xwrap Plus, per square centimeter2026 Medicare rate & RVUs

Medicare pays $127.26 for Q4357 nationally in the office. Local office rates run $109.31–$183.51.

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

What Q4357 covers

Q4357 identifies the Xwrap Plus wound matrix supplied for application to a prepared wound bed; it reports the product, not the wound-preparation or application work. A wound-care clinician or surgeon may use it during treatment of a wound such as a chronic lower-extremity ulcer. The application procedure and the product are represented separately on the claim, with the product quantity reported in square centimeters.

Report Q4357 only with a primary procedure, as CMS classifies it as an add-on code paid within that procedure’s global period. Documentation should identify Xwrap Plus, the wound site, the amount used, and the associated primary procedure; select the application code according to the treated body area and wound area. CMS classifies Q4357 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 Q4357 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

Q4357 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the Q4357 rate is calculated

Each of Q4357’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.

Payment rules and modifiers for Q4357

The CMS indicators that decide how Q4357 is paid alongside other services.

Q4357 compared with similar codes

How to choose

Q4358Wound productXwrap Dual, per square centimeter

Q4358 identifies Xwrap Dual; Q4357 identifies Xwrap Plus. Select the product code that matches the product used.

15271Skin substitute graftFirst 25 cm², trunk/limbs

CPT 15271 reports the application procedure for the trunk, arms, or legs. Q4357 reports the Xwrap Plus product supplied with the procedure.

15273Skin substitute graftLarge trunk or limb wound area

CPT 15273 is the application procedure for the feet. Q4357 identifies the product and is not selected based on the wound’s body site.

Codes related to Q4357

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

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

Open CMS sourceHow we calculate rates