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HCPCS Q4104: Wound matrixMedicare rate & RVUs

Reports Integra Bilayer Wound Matrix used as a wound covering, paired with the primary application procedure and documented by product and area used.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4104 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4104

Wound matrix

Swap in your local Medicare rate.

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4104 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What Q4104 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What Q4104 covers

Q4104 identifies Integra Bilayer Wound Matrix (BMWD), a collagen-based wound matrix with a protective outer layer used to cover partial- and full-thickness wounds. Typical settings include wound-care clinics, outpatient surgery, and hospital-based wound treatment. Clinicians may use it for chronic ulcers, surgical wounds, traumatic wounds, or burns; the treating clinician applies the product to the prepared wound.

Report the product with the primary wound or skin-substitute application procedure, not as a stand-alone service. CMS classifies Q4104 as an add-on paid within the primary procedure’s global period. The code represents the product rather than the clinician’s application work; document the product used and the wound area treated, and report units according to the applicable HCPCS descriptor. CMS also identifies Q4104 as technical-component-only, with interpretation covered by a separate code when applicable.

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 Q4104 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

$109.31$146.41$183.51
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

Q4104 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$111.35Unavailable
Alaska*$135.53Unavailable
Arizona$123.31Unavailable
Arkansas$109.31Unavailable
Atlanta$129.29Unavailable
Austin$134.64Unavailable
Bakersfield$139.47Unavailable
Baltimore/Surr. Cntys$136.55Unavailable
Beaumont$115.80Unavailable
Brazoria$126.11Unavailable

Q4104 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
Q4104 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

How the Q4104 rate is calculated

Each of Q4104’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 · Q4104

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 3.81Malpractice 0.00

3.8100 adjusted RVUs×$33.4009 conversion factor=$127.26

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for Q4104

The CMS indicators that decide how Q4104 is paid alongside other services.

CMS payment indicators · Q4104

Wound matrix

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.

Q4104 compared with similar codes

Compare codes

Q4104 vs Q4105 vs Q4108 vs Q4102: national Medicare rates

Swap in your local Medicare rate.

  • Q4104
    Wound matrix · 0 wRVU
    $127.26
  • Q4105
    Skin substitute · 0 wRVU
    $127.26+$0.00
  • Q4108
    Wound matrix · 0 wRVU
    $127.26+$0.00
  • Q4102
    Wound matrix · 0 wRVU
    $127.26+$0.00

How to choose

Q4105Skin substitute
Q4105 identifies Integra DRT or Omnigraft. Use Q4104 for Integra BMWD; the product documented as applied determines the supply code.
Q4108Wound matrix
Q4108 identifies Integra Matrix rather than BMWD. Distinguish them by the specific product used, not simply by the wound being treated.
Q4102Wound matrix
Q4102 identifies Oasis wound matrix. Q4104 is specific to Integra BMWD, so select the code matching the product used.

Codes related to Q4104

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

Codes related to Q4104
CodeHow it relatesNational office range
Often billed with
15271Skin substitute graftA skin-substitute application procedure for qualifying wounds on the trunk, arms, or legs.$140.17–$205.27
15275Skin substituteA skin-substitute application procedure for qualifying wounds at specified other sites.$143.80–$205.40
Same family
Q4105Skin substituteAnother Integra product code, identifying DRT or Omnigraft rather than BMWD.$109.31–$183.51
Q4108Wound matrixIdentifies Integra Matrix, a different product from Integra BMWD.$109.31–$183.51
Used instead
Q4102Wound matrixIdentifies Oasis wound matrix, a different wound-matrix product.$109.31–$183.51

Q4104 billing questions

Can Q4104 be reported by itself?

No. CMS identifies it as an add-on that must be billed with a primary procedure; payment falls within that procedure’s global period.

Which application procedure is commonly paired with Q4104?

Pair the product with the applicable skin-substitute application procedure, such as the 15271–15278 family. Select the application code based on the wound site and area treated.

How should units be supported?

Document the BMWD product used and the wound area treated. Report units according to the applicable HCPCS descriptor and the documented quantity.

Does Q4104 include the clinician’s application work?

No. Q4104 identifies the product. The primary procedure represents the application service, and CMS places Q4104 within that procedure’s global period.

What does the technical-component-only designation mean?

CMS identifies Q4104 as technical-component-only and states that interpretation is covered by a separate code when applicable.

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 Q4104PPRRVU2026_Oct_nonQPP.csv, line 18,204 (RVU26D)

Open CMS sourceHow we calculate rates

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