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HCPCS Q4427: Skin substituteMedicare rate & RVUs

Reports DermBnd DLN, DL+, or DLX skin-substitute product by square centimeter when furnished with a primary procedure for wound treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4427 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4427

Skin substitute

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 Q4427 → · 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 Q4427 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 Q4427 covers

Q4427 identifies the DermBnd DLN, DL+, or DLX skin-substitute product, measured in square centimeters. It represents the product rather than a separately described physician service. A clinician furnishing the product during wound treatment should document which DermBnd variant was used and the square-centimeter quantity associated with the treated wound. The code does not distinguish among wound locations or clinical settings.

Report Q4427 only with a primary procedure; it is an add-on code, and payment falls within that procedure’s global period. The claim quantity should be supported by the product variant and area documented for the encounter. CMS classifies this as a technical-component-only code, with a separate code covering interpretation. Its physician fee schedule values include practice expense, with zero work and malpractice relative value units.

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 Q4427 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

Q4427 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

Q4427 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
Q4427 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 Q4427 rate is calculated

Each of Q4427’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 · Q4427

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 3.81Malpractice 0.00

3.8100 adjusted RVUs×$33.4009 conversion factor=$127.26

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for Q4427

The CMS indicators that decide how Q4427 is paid alongside other services.

CMS payment indicators · Q4427

Skin substitute

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.

Q4427 compared with similar codes

Compare codes

Q4427 vs Q4426 vs Q4428 vs Q4429: national Medicare rates

Swap in your local Medicare rate.

  • Q4427
    Skin substitute · 0 wRVU
    $127.26
  • Q4426
    Skin substitute · 0 wRVU
    $127.26+$0.00
  • Q4428
    DermBnd skin substitute · 0 wRVU
    $127.26+$0.00
  • Q4429
    DermBnd skin substitute · 0 wRVU
    $127.26+$0.00

How to choose

Q4426Skin substitute
Q4426 identifies DermBnd TL+ or TLX variants; Q4427 identifies DLN, DL+, or DLX variants. Match the code to the specific product used.
Q4428DermBnd skin substitute
Q4428 identifies DermBnd SLN, SL+, or SLX variants. Q4427 is for the DLN, DL+, or DLX variants.
Q4429DermBnd skin substitute
Q4429 identifies DermBnd CHN or CHX variants. Q4427 is for the DLN, DL+, or DLX variants.

Codes related to Q4427

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

Codes related to Q4427
CodeHow it relatesNational office range
Same family
Q4426Skin substituteDermBnd sibling code for TL+ or TLX product variants, reported per square centimeter.$109.31–$183.51
Q4428DermBnd skin substituteDermBnd sibling code for SLN, SL+, or SLX product variants, reported per square centimeter.$109.31–$183.51
Q4429DermBnd skin substituteDermBnd sibling code for CHN or CHX product variants, reported per square centimeter.$109.31–$183.51

Q4427 billing questions

Can Q4427 be reported by itself?

No. It is an add-on code and must be billed with a primary procedure; payment is within that procedure’s global period.

How should the number of units be determined?

Use the documented square-centimeter quantity for the DermBnd product. The record should identify the DLN, DL+, or DLX variant and the quantity associated with the wound treatment.

How does Q4427 differ from Q4426?

Q4427 identifies DermBnd DLN, DL+, or DLX; Q4426 identifies DermBnd TL+, or TLX. Select the code matching the product variant used.

Does Q4427 include interpretation?

No. CMS classifies Q4427 as technical-component-only; a separate code covers interpretation.

What documentation supports Q4427?

Document the DermBnd variant, the square-centimeter quantity, and the primary procedure billed with this add-on code.

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 Q4427PPRRVU2026_Oct_nonQPP.csv, line 18,512 (RVU26D)

Open CMS sourceHow we calculate rates

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