HCPCS Q4108: Wound matrixMedicare rate & RVUs

Report Integra Matrix for the wound-matrix product used with a primary wound procedure, with units reflecting the product area represented by the code.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4108 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4108

Wound matrix

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4108 →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 Q4108 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 Q4108 covers

Q4108 identifies Integra Matrix, a wound-care matrix product used on a prepared wound bed. It may be encountered in wound-care services and surgical treatment of wounds; wound-care clinicians and surgeons typically document the wound treated and the product used. It is distinct from other Integra products, including bilayer matrix wound dressing, dermal regeneration template, and flowable wound matrix.

CMS classifies Q4108 as an add-on code, so report it only with a primary procedure; its payment falls within that procedure’s global period. The code is technical-component-only, with interpretation covered by a separate code. Documentation should identify Integra Matrix, the treated wound site, the primary procedure, and the quantity applied. Use the product’s square-centimeter unit when reporting the quantity, and ensure the primary procedure matches the service performed and wound location.

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 Q4108 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

Q4108 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

Q4108 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
Q4108 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 Q4108 rate is calculated

Each of Q4108’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 · Q4108

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 Q4108

The CMS indicators that decide how Q4108 is paid alongside other services.

CMS payment indicators · Q4108

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.

Q4108 compared with similar codes

Compare codes · National

4 codes, side by side

  • Q4108

    Wound matrix0 wRVU

    $127.26

  • Q4104

    Wound matrix0 wRVU

    $127.26+$0.00

  • Q4105

    Skin substitute0 wRVU

    $127.26+$0.00

  • Q4114

    Not on the physician fee schedule0 wRVU

    Not priced

How to choose

Q4104Wound matrix
Q4104 is for Integra Bilayer Matrix Wound Dressing. Use Q4108 for Integra Matrix, based on the product documented and supplied.
Q4105Skin substitute
Q4105 identifies Integra Dermal Regeneration Template or Omnigraft. It is not interchangeable with the Integra Matrix product reported under Q4108.
Q4114Integra flowable wound matri
Q4114 identifies Integra Flowable Wound Matrix. Select it for that flowable product, not for Integra Matrix reported under Q4108.

Q4108 billing questions

How is Q4108 different from Q4104 or Q4105?

Q4108 identifies Integra Matrix. Q4104 identifies Integra Bilayer Matrix Wound Dressing, while Q4105 identifies Integra Dermal Regeneration Template or Omnigraft; report the product actually used.

Can Q4108 be billed by itself?

No. CMS identifies it as an add-on code, so it must be reported with a primary procedure and is paid within that procedure’s global period.

What should the record support?

Document the Integra Matrix product, wound site, primary procedure, and quantity applied. The reported units should reflect the product quantity represented in square centimeters.

Does Q4108 include interpretation?

CMS classifies Q4108 as technical-component-only; a separate code covers interpretation. The record and claim should distinguish the technical service from any separately coded interpretation.

Which application procedure may be reported with Q4108?

A skin-substitute application procedure may serve as the primary procedure, with the specific code selected according to the treated site and service. Q4108 is not reported without that primary 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 Q4108PPRRVU2026_Oct_nonQPP.csv, line 18,207 (RVU26D)

Open CMS sourceHow we calculate rates

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