HCPCS Q4156: Wound materialMedicare rate & RVUs

Medicare pays $127.26 for Q4156 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 Q4156 covers

Q4156 identifies Neox 100 or Clarix 100 placental-tissue material used as a wound covering, measured by square centimeter; it represents the material, not the clinician’s work applying it. These products may be used in outpatient wound care, including treatment of diabetic foot ulcers or venous leg ulcers. A physician, podiatrist, or other qualified practitioner typically applies the material after preparing the wound bed in a clinic or hospital outpatient department.

Report the product quantity in square-centimeter units and pair the code with the primary wound-treatment procedure. Documentation should identify the product, wound site, amount used, and associated application service. CMS classifies Q4156 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. It is also technical-component-only; a separate code covers 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 Q4156 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

Q4156 rates by state

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

How the Q4156 rate is calculated

Each of Q4156’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 Q4156

The CMS indicators that decide how Q4156 is paid alongside other services.

Q4156 compared with similar codes

How to choose

Q4155Neoxflo or clarixflo 1 mg

Q4155 identifies Neoxflo or Clarixflo and uses a milligram unit. Q4156 is for Neox 100 or Clarix 100 and is measured per square centimeter.

Q4148Wound tissue

Q4148 identifies a different Neox or Clarix product form. Use Q4156 only when the supplied product is Neox 100 or Clarix 100.

15271Skin substitute graft

15271 reports the primary wound-treatment application service for qualifying sites on the trunk, arms, or legs; Q4156 reports the associated product.

Codes related to Q4156

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