HCPCS Q4286: Wound productMedicare rate & RVUs
Reports Nudyn SL or SLW wound product by square centimeter when supplied for use with a qualifying primary wound procedure.
Medicare pays $127.26 for Q4286 nationally in the office. Local office rates run $109.31–$183.51.
Medicare rate · Q4286
Wound product
Swap in your local Medicare rate.
- Work RVUs
- 0
- Total RVUs
- 3.81
- Global days
- ZZZ
National rate · 2026
$127.26
Office setting, before claim adjustments.
See every locality for Q4286 → · 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
What Q4286 covers
Q4286 identifies Nudyn SL or SLW by the square centimeter for wound-care use. The product is typically applied by a clinician treating a wound, such as a chronic ulcer, in a wound clinic, office, or hospital setting. This code represents the product quantity, not the clinician’s wound application service; the applicable primary procedure is reported separately.
Select Q4286 when the product used is specifically Nudyn SL or SLW, and document the product and square-centimeter quantity. CMS classifies it as an add-on code: bill it only with a primary procedure, and its payment falls within that procedure’s global period. It is technical-component-only; interpretation is covered by a separate code. The record should support the wound treated, product identity, amount used, and related 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 Q4286 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 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $111.35 | Unavailable |
| Alaska* | $135.53 | Unavailable |
| Arizona | $123.31 | Unavailable |
| Arkansas | $109.31 | Unavailable |
| Atlanta | $129.29 | Unavailable |
| Austin | $134.64 | Unavailable |
| Bakersfield | $139.47 | Unavailable |
| Baltimore/Surr. Cntys | $136.55 | Unavailable |
| Beaumont | $115.80 | Unavailable |
| Brazoria | $126.11 | Unavailable |
| Chicago | $127.89 | Unavailable |
| Chico | $139.47 | Unavailable |
| Colorado | $135.40 | Unavailable |
| Connecticut | $137.06 | Unavailable |
| Dallas | $126.75 | Unavailable |
| Dc + Md/Va Suburbs | $149.91 | Unavailable |
| Delaware | $125.73 | Unavailable |
| Detroit | $122.80 | Unavailable |
| East St. Louis | $117.08 | Unavailable |
| El Centro | $139.47 | Unavailable |
| Fort Lauderdale | $128.91 | Unavailable |
| Fort Worth | $125.48 | Unavailable |
| Fresno | $139.47 | Unavailable |
| Galveston | $126.37 | Unavailable |
| Hanford-Corcoran | $139.47 | Unavailable |
| Hawaii, Guam | $144.69 | Unavailable |
| Houston | $126.37 | Unavailable |
| Idaho | $117.08 | Unavailable |
| Indiana | $117.97 | Unavailable |
| Iowa | $116.44 | Unavailable |
| Kansas | $115.04 | Unavailable |
| Kentucky | $113.13 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $150.55 | Unavailable |
| Madera | $139.47 | Unavailable |
| Manhattan | $147.87 | Unavailable |
| Merced | $139.47 | Unavailable |
| Metropolitan Boston | $151.95 | Unavailable |
| Metropolitan Kansas City | $119.49 | Unavailable |
| Metropolitan Philadelphia | $132.47 | Unavailable |
| Metropolitan St. Louis | $121.15 | Unavailable |
| Miami | $132.47 | Unavailable |
| Minnesota | $130.95 | Unavailable |
| Mississippi | $109.57 | Unavailable |
| Modesto | $139.47 | Unavailable |
| Montana** | $127.26 | Unavailable |
| Napa | $167.73 | Unavailable |
| Nebraska | $117.46 | Unavailable |
| Nevada** | $127.38 | Unavailable |
| New Hampshire | $132.47 | Unavailable |
| New Mexico | $116.70 | Unavailable |
| New Orleans | $119.75 | Unavailable |
| North Carolina | $118.73 | Unavailable |
| North Dakota** | $127.26 | Unavailable |
| Northern Nj | $147.62 | Unavailable |
| Nyc Suburbs/Long Island | $151.31 | Unavailable |
| Ohio | $116.19 | Unavailable |
| Oklahoma | $113.64 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $150.42 | Unavailable |
| Portland | $141.38 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $139.35 | Unavailable |
| Puerto Rico | $128.66 | Unavailable |
| Queens | $150.42 | Unavailable |
| Redding | $139.47 | Unavailable |
| Rest Of California | $139.47 | Unavailable |
| Rest Of Florida | $121.66 | Unavailable |
| Rest Of Georgia | $113.51 | Unavailable |
| Rest Of Illinois | $116.19 | Unavailable |
| Rest Of Louisiana | $112.62 | Unavailable |
| Rest Of Maine | $117.08 | Unavailable |
| Rest Of Maryland | $128.78 | Unavailable |
| Rest Of Massachusetts | $134.00 | Unavailable |
| Rest Of Michigan | $116.19 | Unavailable |
| Rest Of Missouri | $109.70 | Unavailable |
| Rest Of New Jersey | $138.97 | Unavailable |
| Rest Of New York | $120.89 | Unavailable |
| Rest Of Oregon | $126.75 | Unavailable |
| Rest Of Pennsylvania | $116.82 | Unavailable |
| Rest Of Texas | $120.77 | Unavailable |
| Rest Of Washington | $134.00 | Unavailable |
| Rhode Island | $131.46 | Unavailable |
| Riverside-San Bernardino-Ontario | $139.47 | Unavailable |
| Sacramento-Roseville-Folsom | $148.00 | Unavailable |
| Salinas | $147.49 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $152.20 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $179.43 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $179.43 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $183.51 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $183.51 | Unavailable |
| San Luis Obispo-Paso Robles | $144.95 | Unavailable |
| Santa Cruz-Watsonville | $154.62 | Unavailable |
| Santa Maria-Santa Barbara | $148.38 | Unavailable |
| Santa Rosa-Petaluma | $156.27 | Unavailable |
| Seattle (King Cnty) | $156.14 | Unavailable |
| South Carolina | $117.59 | Unavailable |
| South Dakota** | $127.26 | Unavailable |
| Southern Maine | $126.11 | Unavailable |
| Stockton | $139.47 | Unavailable |
| Suburban Chicago | $130.69 | Unavailable |
| Tennessee | $115.68 | Unavailable |
| Utah | $119.62 | Unavailable |
| Vallejo | $167.73 | Unavailable |
| Vermont | $125.98 | Unavailable |
| Virgin Islands | $128.66 | Unavailable |
| Virginia | $125.09 | Unavailable |
| Visalia | $139.47 | Unavailable |
| West Virginia | $110.59 | Unavailable |
| Wisconsin | $121.91 | Unavailable |
| Wyoming** | $127.26 | Unavailable |
| Yuba City | $139.47 | Unavailable |
Q4286 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $135.53 | 1 |
| AL | $111.35 | 1 |
| AR | $109.31 | 1 |
| AZ | $123.31 | 1 |
| CA | $139.47–$183.51 | 29 |
| CO | $135.40 | 1 |
| CT | $137.06 | 1 |
| DC | $149.91 | 1 |
| DE | $125.73 | 1 |
| FL | $121.66–$132.47 | 3 |
| GA | $113.51–$129.29 | 2 |
| GU | $144.69 | 1 |
| HI | $144.69 | 1 |
| IA | $116.44 | 1 |
| ID | $117.08 | 1 |
| IL | $116.19–$130.69 | 4 |
| IN | $117.97 | 1 |
| KS | $115.04 | 1 |
| KY | $113.13 | 1 |
| LA | $112.62–$119.75 | 2 |
| MA | $134.00–$151.95 | 2 |
| MD | $128.78–$149.91 | 3 |
| ME | $117.08–$126.11 | 2 |
| MI | $116.19–$122.80 | 2 |
| MN | $130.95 | 1 |
| MO | $109.70–$121.15 | 3 |
| MS | $109.57 | 1 |
| MT | $127.26 | 1 |
| NC | $118.73 | 1 |
| ND | $127.26 | 1 |
| NE | $117.46 | 1 |
| NH | $132.47 | 1 |
| NJ | $138.97–$147.62 | 2 |
| NM | $116.70 | 1 |
| NV | $127.38 | 1 |
| NY | $120.89–$151.31 | 5 |
| OH | $116.19 | 1 |
| OK | $113.64 | 1 |
| OR | $126.75–$141.38 | 2 |
| PA | $116.82–$132.47 | 2 |
| PR | $128.66 | 1 |
| RI | $131.46 | 1 |
| SC | $117.59 | 1 |
| SD | $127.26 | 1 |
| TN | $115.68 | 1 |
| TX | $115.80–$134.64 | 8 |
| UT | $119.62 | 1 |
| VA | $125.09–$149.91 | 2 |
| VI | $128.66 | 1 |
| VT | $125.98 | 1 |
| WA | $134.00–$156.14 | 2 |
| WI | $121.91 | 1 |
| WV | $110.59 | 1 |
| WY | $127.26 | 1 |
How the Q4286 rate is calculated
Each of Q4286’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 · Q4286
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 3.81Malpractice 0.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4286
The CMS indicators that decide how Q4286 is paid alongside other services.
CMS payment indicators · Q4286
Wound product
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4286 compared with similar codes
Compare codes
Q4286 vs Q4285 vs 15271 vs Q4284: national Medicare rates
Swap in your local Medicare rate.
How to choose
- Q4285Wound matrix
- Q4285 identifies Nudyn DL or DL mesh, while Q4286 identifies Nudyn SL or SLW. The product used determines which supply code applies.
- 15271Skin substitute graft
- Q4286 reports the Nudyn product quantity; 15271 reports a primary wound-application procedure when its site and area criteria are met.
- Q4284Wound product
- Q4284 identifies Dermabind SL, not Nudyn SL or SLW. Use the code for the product actually supplied.
Q4286 billing questions
When should Q4286 be selected instead of Q4285?
Use Q4286 for Nudyn SL or SLW. Q4285 identifies Nudyn DL or DL mesh, so select the code matching the product actually used.
Is Q4286 reported by wound or by square centimeter?
The descriptor is per square centimeter. Document the product quantity in square centimeters and ensure the reported units reflect that quantity.
Can Q4286 be billed without a primary procedure?
No. CMS identifies it as an add-on code that must be billed with a primary procedure; payment is within that procedure’s global period.
Does Q4286 include interpretation?
No. CMS classifies Q4286 as technical-component-only and indicates that a separate code covers interpretation.
What documentation supports Q4286?
Record the wound treated, the Nudyn SL or SLW product used, its square-centimeter quantity, and the associated primary procedure.
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
Fee sheets
Put Q4286 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →