HCPCS Q4125: Dermal allograftMedicare rate & RVUs

Medicare pays $127.26 for Q4125 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 Q4125 covers

Q4125 identifies ArthroFlex, a human acellular dermal matrix used as graft material in soft-tissue repair or reinforcement. Orthopedic surgeons commonly use dermal grafts in procedures such as rotator cuff repair; other reconstructive procedures may use them to reinforce or replace deficient soft tissue. The code represents the product, not the surgeon’s operative work, and is reported by the treating facility or clinician furnishing the material according to the applicable claim setting.

Report the quantity in square centimeters and retain documentation showing the product used and the area applied. CMS classifies Q4125 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. CMS also classifies it as technical-component-only; a separate code covers interpretation. The CMS file assigns no physician work RVUs to Q4125, so the code represents the technical side rather than professional 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 Q4125 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

Q4125 rates by state

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

How the Q4125 rate is calculated

Each of Q4125’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 Q4125

The CMS indicators that decide how Q4125 is paid alongside other services.

Q4125 compared with similar codes

How to choose

Q4128Skin matrix

Q4128 identifies FlexHD and related products; Q4125 identifies ArthroFlex. Select the code matching the product furnished.

Q4116Dermal matrix

Q4116 is the product-specific code for AlloDerm. It is not the code for ArthroFlex, even when both are used as dermal matrices.

Q4122Wound matrix

Q4122 identifies DermACELL AWM, while Q4125 identifies ArthroFlex. The product record determines which code applies.

Codes related to Q4125

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