HCPCS Q4186: EpiFix materialMedicare rate & RVUs

Medicare pays $127.26 for Q4186 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 Q4186 covers

Q4186 identifies EpiFix, an amniotic membrane product used as a wound covering. Wound-care clinicians, podiatrists, and surgeons may apply it to chronic wounds such as diabetic foot ulcers or venous leg ulcers in office or hospital outpatient settings. The product code represents the material, not the clinician’s wound assessment or the application service.

Report one unit for each square centimeter represented by the product amount, supported by the product record and wound documentation. CMS classifies Q4186 as an add-on code: bill 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 a separate code covering interpretation. Pair it with the applicable wound procedure for the treated site and area; the record should identify the product, wound location, treated area, and amount used.

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 Q4186 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

Q4186 rates by state

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

How the Q4186 rate is calculated

Each of Q4186’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 Q4186

The CMS indicators that decide how Q4186 is paid alongside other services.

Q4186 compared with similar codes

How to choose

Q4187Wound product

Use Q4186 for EpiFix and Q4187 for Epicord. Both are product-specific codes with a square-centimeter unit, but they identify different materials.

Q4188Wound product

Q4188 identifies AmnioArmor, not EpiFix. Choose according to the product furnished, not simply because both are reported by area.

15271Skin substitute graft

Q4186 reports the EpiFix material; 15271 reports an application procedure for qualifying trunk, arm, or leg wounds. They serve different parts of the encounter.

Codes related to Q4186

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