HCPCS Q4165: Wound matrixMedicare rate & RVUs

Medicare pays $127.26 for Q4165 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 Q4165 covers

Q4165 identifies Keramatrix or Kerasorb wound matrix supplied for placement on a wound. A wound-care clinician, surgeon, or podiatrist may use the product as part of treating a wound that requires a matrix dressing. The code represents the named product, not the clinician’s wound assessment or the primary procedure used to prepare or treat the wound. The claim unit is based on square centimeters, so the product name and quantity used should be clear in the record.

CMS classifies Q4165 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. CMS also identifies it as technical-component-only, with interpretation covered by a separate code when applicable. Its physician fee schedule valuation assigns practice-expense value but no work or malpractice RVUs. Documentation should identify Keramatrix or Kerasorb, the wound treated, the amount furnished, and the associated primary procedure.

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 Q4165 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

Q4165 rates by state

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

How the Q4165 rate is calculated

Each of Q4165’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 Q4165

The CMS indicators that decide how Q4165 is paid alongside other services.

Q4165 compared with similar codes

How to choose

Q4154Wound matrix

Q4154 identifies Biovance, while Q4165 identifies Keramatrix or Kerasorb. Choose the code for the product actually furnished.

Q4158Wound matrix

Q4158 identifies Kerecis Omega3; Q4165 is for Keramatrix or Kerasorb. The product name, not a general wound-matrix resemblance, determines the code.

Q4166Wound matrix

Q4166 identifies Cytal, whereas Q4165 identifies Keramatrix or Kerasorb. Report the specific product used and its corresponding code.

Codes related to Q4165

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