HCPCS Q4439: Skin substituteMedicare rate & RVUs

Medicare pays $127.26 for Q4439 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 Q4439 covers

Q4439 identifies Instagraft furnished as a skin-substitute product for wound coverage, rather than the work of preparing the wound or applying the material. It is reported in square-centimeter units for the product used on a treated wound. Wound-care physicians, surgeons, podiatrists, and hospital outpatient departments may furnish the product during graft treatment; the application service is represented separately by the appropriate skin-substitute application procedure.

Report Q4439 only with a qualifying primary procedure, as CMS classifies it as an add-on paid within that procedure’s global period. Select the companion application code according to the treated anatomic site and total wound area. Document Instagraft by name, the wound treated, the area covered, and the quantity used to support the reported units. CMS identifies Q4439 as technical-component-only, with interpretation covered by a separate code; Q4439 does not represent the interpreting service.

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 Q4439 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

Q4439 rates by state

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

How the Q4439 rate is calculated

Each of Q4439’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 Q4439

The CMS indicators that decide how Q4439 is paid alongside other services.

Q4439 compared with similar codes

How to choose

Q4438Skin substitute

Q4438 identifies Pretect, while Q4439 identifies Instagraft. Use the code for the product actually furnished; the shared per-square-centimeter basis does not make the codes interchangeable.

Q4440Wound matrix

Q4440 identifies Curamatrix rather than Instagraft. Distinguish these product-supply codes by the material furnished, not by wound size.

15271Skin substitute graft

Q4439 reports the Instagraft product by area; 15271 reports the application service for qualifying wounds on the trunk, arms, or legs. The application code is the primary procedure.

Codes related to Q4439

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