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HCPCS Q4254: Wound matrixMedicare rate & RVUs

Q4254 reports NovaFix DL, an amniotic membrane wound covering, by the square centimeter used with a primary wound-treatment procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4254 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4254

Wound matrix

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4254 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What Q4254 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What Q4254 covers

NovaFix DL is a dual-layer amniotic membrane allograft used as a covering for wounds, including chronic or difficult-to-heal wounds. Wound-care clinicians, podiatrists, and surgeons may apply it to a prepared wound bed in outpatient or facility settings. Q4254 identifies the product, not the wound preparation or application service.

Report the documented square centimeters of NovaFix DL used, and pair the code with the primary procedure. The record should identify the product, the treated wound, the amount used, and the application procedure. CMS classifies Q4254 as an add-on code: it is billed only with a primary procedure and paid within that procedure's global period. It is also a technical-component-only code; a separate code covers interpretation. The primary procedure accounts for the application work, while Q4254 identifies the product amount.

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 Q4254 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$109.31 to $183.51

$109.31$146.41$183.51
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

Q4254 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$111.35Unavailable
Alaska*$135.53Unavailable
Arizona$123.31Unavailable
Arkansas$109.31Unavailable
Atlanta$129.29Unavailable
Austin$134.64Unavailable
Bakersfield$139.47Unavailable
Baltimore/Surr. Cntys$136.55Unavailable
Beaumont$115.80Unavailable
Brazoria$126.11Unavailable

Q4254 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$109.31

$161.49

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
Q4254 office rate range by state
State / territoryOffice rate rangeLocalities
AK$135.531
AL$111.351
AR$109.311
AZ$123.311
CA$139.47–$183.5129
CO$135.401
CT$137.061
DC$149.911
DE$125.731
FL$121.66–$132.473
GA$113.51–$129.292
GU$144.691
HI$144.691
IA$116.441
ID$117.081
IL$116.19–$130.694
IN$117.971
KS$115.041
KY$113.131
LA$112.62–$119.752
MA$134.00–$151.952
MD$128.78–$149.913
ME$117.08–$126.112
MI$116.19–$122.802
MN$130.951
MO$109.70–$121.153
MS$109.571
MT$127.261
NC$118.731
ND$127.261
NE$117.461
NH$132.471
NJ$138.97–$147.622
NM$116.701
NV$127.381
NY$120.89–$151.315
OH$116.191
OK$113.641
OR$126.75–$141.382
PA$116.82–$132.472
PR$128.661
RI$131.461
SC$117.591
SD$127.261
TN$115.681
TX$115.80–$134.648
UT$119.621
VA$125.09–$149.912
VI$128.661
VT$125.981
WA$134.00–$156.142
WI$121.911
WV$110.591
WY$127.261

How the Q4254 rate is calculated

Each of Q4254’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.

How the rate is built · Q4254

RVUs × geographic indexes × conversion factor

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense3.81

3.81 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

3.8100

Conversion factor

$33.4009

Medicare rate

$127.26

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for Q4254

The CMS indicators that decide how Q4254 is paid alongside other services.

CMS payment indicators · Q4254

Wound matrix

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical3Technical component only.

Q4254 compared with similar codes

Compare codes · National

4 codes, side by side

  • Q4254

    Wound matrix0 wRVU

    $127.26

  • Q4253

    Amniotic membrane0 wRVU

    $127.26+$0.00

  • Q4255

    Wound product0 wRVU

    $127.26+$0.00

  • 15271

    Skin substitute graft1.46 wRVU

    $157.99+$30.73

How to choose

Q4253Amniotic membrane
Q4253 identifies Zenith amniotic membrane. Use Q4254 only when NovaFix DL is the product applied.
Q4255Wound product
Q4255 identifies Reguard for topical use. Q4254 identifies NovaFix DL and is measured per square centimeter.
15271Skin substitute graft
15271 reports the primary skin-substitute application service for qualifying wounds; Q4254 identifies the NovaFix DL product amount.

Codes related to Q4254

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to Q4254
CodeHow it relatesNational office range
Primary code
15271Skin substitute graftPrimary skin-substitute application procedure for qualifying wounds on the trunk or extremities.$140.17–$205.27
Often billed with
15272Skin substitute graftMay report additional qualifying application area alongside the primary application procedure.$23.02–$32.02
Used instead
Q4253Amniotic membraneIdentifies Zenith amniotic membrane rather than NovaFix DL.$109.31–$183.51
Q4255Wound productIdentifies Reguard topical product rather than NovaFix DL.$109.31–$183.51

Q4254 billing questions

When should Q4254 be selected instead of another skin-substitute product code?

Use Q4254 when the product applied is NovaFix DL. Other product-specific codes identify different products, even when they are also used as wound coverings.

Can Q4254 be billed by itself?

No. CMS identifies it as an add-on code that must be billed with a primary procedure.

How should the quantity be reported?

Report the square centimeters of NovaFix DL used, supported by documentation of the treated wound and product amount.

Does Q4254 include the wound application service?

No. Q4254 identifies the product amount; report the applicable primary procedure for the wound treatment.

What does the technical-component-only classification mean?

Q4254 represents the technical component. CMS specifies that a separate code covers interpretation.

What procedure codes may be reported with Q4254?

Skin-substitute application codes such as 15271 and, when additional treated area qualifies, 15272 may be reported for the application service. Q4254 remains the product-specific line for NovaFix DL.

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

Show the CMS file lines behind this rate
RVUs for Q4254PPRRVU2026_Oct_nonQPP.csv, line 18,342 (RVU26D)

Open CMS sourceHow we calculate rates

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