HCPCS Q4116: Dermal matrixMedicare rate & RVUs

Medicare pays $127.26 for Q4116 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 Q4116 covers

AlloDerm is a human-derived acellular dermal matrix used as a tissue scaffold in wound coverage and soft-tissue reconstruction. It may be placed by surgeons or wound-care clinicians in settings such as outpatient wound treatment or reconstructive surgery. Q4116 identifies the product, not the work of preparing the site or placing the matrix; the applicable procedure is reported separately. The code is reported by square centimeter, so the documented product area—not the number of pieces alone—supports the units billed.

Select Q4116 only when the product used is AlloDerm, rather than another skin substitute or dermal matrix. The record should identify the product, the treated site, the area used, and the primary procedure. CMS classifies this as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. It is technical-component-only; a separate code covers interpretation. CMS assigns no physician work to Q4116, with payment associated with practice expense.

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 Q4116 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

Q4116 rates by state

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

How the Q4116 rate is calculated

Each of Q4116’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 Q4116

The CMS indicators that decide how Q4116 is paid alongside other services.

Q4116 compared with similar codes

How to choose

Q4115Skin substitute

Q4115 identifies AlloSkin, while Q4116 identifies AlloDerm. Choose the code matching the product documented as used.

Q4107GraftJacket

Q4107 identifies GraftJacket rather than AlloDerm. These are separate product codes even when used for similar dermal-matrix needs.

Q4122Wound matrix

Q4122 identifies DermACELL, not AlloDerm. Product identity determines which supply code applies.

Codes related to Q4116

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