Q4165 identifies Keramatrix or Kerasorb. Q4166 is specific to Cytal; select according to the product actually furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4166 in Chico
Office / nonfacility
$139.47
Base rate per service
Facility setting
Not available in this setting
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Wound care supply
About Q4166: Cytal wound matrix supply
Reports Cytal extracellular matrix material used on a wound bed, measured by area and billed with the related wound application procedure.
Cytal is an extracellular matrix wound product derived from porcine urinary bladder tissue. A wound-care clinician may apply it to a prepared wound bed, including in the treatment of chronic wounds such as diabetic foot or venous leg ulcers. The product amount is reported by the square centimeter, rather than by the number of wounds or a time increment.
Report Q4166 with the primary wound application procedure for the same treatment, using documentation that identifies Cytal, the treated wound site, and the quantity applied in square centimeters. CMS classifies this as an add-on code: it must be billed with a primary procedure and is paid within that procedure's global period. CMS also identifies it as technical-component-only, with interpretation covered by a separate code rather than this line. The application service and the Cytal material are distinct reported items.
CMS billing rules for Q4166
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU3.81 · 100%
- Malpractice RVU0.00 · 0%
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.
Q4166 compared with similar codes
Office rates for Chico, from the same CMS release.
Q4167 identifies TruSkin, not Cytal. Both are area-based wound product codes, but the product determines which code applies.
15271 reports the wound application service for qualifying trunk or extremity sites. Q4166 reports the Cytal material and must accompany a primary procedure.
The same code, a different location
How does Chico compare?
In Bakersfield, the office rate for Q4166 is $139.47—the same base rate than the $139.47 rate in Chico. Both use the same code, release and participation basis.
Q4166 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
$139.47
$139.47
The same base rate than Chico
$139.47
The same base rate than Chico
$139.47
The same base rate than Chico
$139.47
The same base rate than Chico
$11.08 higher than Chico
$139.47
The same base rate than Chico
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
Across 109 of 109 CMS payment localities with a supported office rate, Q4166 ranges from $109.31 in Arkansas to $183.51 in San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty). This is a geographic range, not an average.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Modesto
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Napa
California · Q4166
Office
$167.73
Facility
Unavailable
$28.26 higher than Chico for the office setting.
Oxnard-Thousand Oaks-Ventura
California · Q4166
Office
$150.42
Facility
Unavailable
$10.95 higher than Chico for the office setting.
Redding
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Rest Of California
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Riverside-San Bernardino-Ontario
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Sacramento-Roseville-Folsom
California · Q4166
Office
$148.00
Facility
Unavailable
$8.53 higher than Chico for the office setting.
Salinas
California · Q4166
Office
$147.49
Facility
Unavailable
$8.02 higher than Chico for the office setting.
San Diego-Chula Vista-Carlsbad
California · Q4166
Office
$152.20
Facility
Unavailable
$12.73 higher than Chico for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · Q4166
Office
$179.43
Facility
Unavailable
$39.96 higher than Chico for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · Q4166
Office
$179.43
Facility
Unavailable
$39.96 higher than Chico for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · Q4166
Office
$183.51
Facility
Unavailable
$44.04 higher than Chico for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · Q4166
Office
$183.51
Facility
Unavailable
$44.04 higher than Chico for the office setting.
San Luis Obispo-Paso Robles
California · Q4166
Office
$144.95
Facility
Unavailable
$5.48 higher than Chico for the office setting.
Santa Cruz-Watsonville
California · Q4166
Office
$154.62
Facility
Unavailable
$15.15 higher than Chico for the office setting.
Santa Maria-Santa Barbara
California · Q4166
Office
$148.38
Facility
Unavailable
$8.91 higher than Chico for the office setting.
Santa Rosa-Petaluma
California · Q4166
Office
$156.27
Facility
Unavailable
$16.80 higher than Chico for the office setting.
Stockton
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Vallejo
California · Q4166
Office
$167.73
Facility
Unavailable
$28.26 higher than Chico for the office setting.
Visalia
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Yuba City
California · Q4166
Office
$139.47
Facility
Unavailable
The same base rate than Chico for the office setting.
Dc + Md/Va Suburbs
District of Columbia · Q4166
Office
$149.91
Facility
Unavailable
$10.44 higher than Chico for the office setting.
Miami
Florida · Q4166
Office
$132.47
Facility
Unavailable
$7.00 lower than Chico for the office setting.
Chicago
Illinois · Q4166
Office
$127.89
Facility
Unavailable
$11.58 lower than Chico for the office setting.
Manhattan
New York · Q4166
Office
$147.87
Facility
Unavailable
$8.40 higher than Chico for the office setting.
Alaska*
Alaska · Q4166
Office
$135.53
Facility
Unavailable
$3.94 lower than Chico for the office setting.
Alabama
Alabama · Q4166
Office
$111.35
Facility
Unavailable
$28.12 lower than Chico for the office setting.
Arkansas
Arkansas · Q4166
Office
$109.31
Facility
Unavailable
$30.16 lower than Chico for the office setting.
Arizona
Arizona · Q4166
Office
$123.31
Facility
Unavailable
$16.16 lower than Chico for the office setting.
Colorado
Colorado · Q4166
Office
$135.40
Facility
Unavailable
$4.07 lower than Chico for the office setting.
Connecticut
Connecticut · Q4166
Office
$137.06
Facility
Unavailable
$2.41 lower than Chico for the office setting.
Delaware
Delaware · Q4166
Office
$125.73
Facility
Unavailable
$13.74 lower than Chico for the office setting.
Fort Lauderdale
Florida · Q4166
Office
$128.91
Facility
Unavailable
$10.56 lower than Chico for the office setting.
Rest Of Florida
Florida · Q4166
Office
$121.66
Facility
Unavailable
$17.81 lower than Chico for the office setting.
Atlanta
Georgia · Q4166
Office
$129.29
Facility
Unavailable
$10.18 lower than Chico for the office setting.
Rest Of Georgia
Georgia · Q4166
Office
$113.51
Facility
Unavailable
$25.96 lower than Chico for the office setting.
Hawaii, Guam
Hawaii · Q4166
Office
$144.69
Facility
Unavailable
$5.22 higher than Chico for the office setting.
Iowa
Iowa · Q4166
Office
$116.44
Facility
Unavailable
$23.03 lower than Chico for the office setting.
Idaho
Idaho · Q4166
Office
$117.08
Facility
Unavailable
$22.39 lower than Chico for the office setting.
East St. Louis
Illinois · Q4166
Office
$117.08
Facility
Unavailable
$22.39 lower than Chico for the office setting.
Rest Of Illinois
Illinois · Q4166
Office
$116.19
Facility
Unavailable
$23.28 lower than Chico for the office setting.
Suburban Chicago
Illinois · Q4166
Office
$130.69
Facility
Unavailable
$8.78 lower than Chico for the office setting.
Indiana
Indiana · Q4166
Office
$117.97
Facility
Unavailable
$21.50 lower than Chico for the office setting.
Kansas
Kansas · Q4166
Office
$115.04
Facility
Unavailable
$24.43 lower than Chico for the office setting.
Kentucky
Kentucky · Q4166
Office
$113.13
Facility
Unavailable
$26.34 lower than Chico for the office setting.
New Orleans
Louisiana · Q4166
Office
$119.75
Facility
Unavailable
$19.72 lower than Chico for the office setting.
Rest Of Louisiana
Louisiana · Q4166
Office
$112.62
Facility
Unavailable
$26.85 lower than Chico for the office setting.
Metropolitan Boston
Massachusetts · Q4166
Office
$151.95
Facility
Unavailable
$12.48 higher than Chico for the office setting.
Rest Of Massachusetts
Massachusetts · Q4166
Office
$134.00
Facility
Unavailable
$5.47 lower than Chico for the office setting.
Baltimore/Surr. Cntys
Maryland · Q4166
Office
$136.55
Facility
Unavailable
$2.92 lower than Chico for the office setting.
Rest Of Maryland
Maryland · Q4166
Office
$128.78
Facility
Unavailable
$10.69 lower than Chico for the office setting.
Rest Of Maine
Maine · Q4166
Office
$117.08
Facility
Unavailable
$22.39 lower than Chico for the office setting.
Southern Maine
Maine · Q4166
Office
$126.11
Facility
Unavailable
$13.36 lower than Chico for the office setting.
Detroit
Michigan · Q4166
Office
$122.80
Facility
Unavailable
$16.67 lower than Chico for the office setting.
Rest Of Michigan
Michigan · Q4166
Office
$116.19
Facility
Unavailable
$23.28 lower than Chico for the office setting.
Minnesota
Minnesota · Q4166
Office
$130.95
Facility
Unavailable
$8.52 lower than Chico for the office setting.
Metropolitan Kansas City
Missouri · Q4166
Office
$119.49
Facility
Unavailable
$19.98 lower than Chico for the office setting.
Metropolitan St. Louis
Missouri · Q4166
Office
$121.15
Facility
Unavailable
$18.32 lower than Chico for the office setting.
Rest Of Missouri
Missouri · Q4166
Office
$109.70
Facility
Unavailable
$29.77 lower than Chico for the office setting.
Mississippi
Mississippi · Q4166
Office
$109.57
Facility
Unavailable
$29.90 lower than Chico for the office setting.
Montana**
Montana · Q4166
Office
$127.26
Facility
Unavailable
$12.21 lower than Chico for the office setting.
North Carolina
North Carolina · Q4166
Office
$118.73
Facility
Unavailable
$20.74 lower than Chico for the office setting.
North Dakota**
North Dakota · Q4166
Office
$127.26
Facility
Unavailable
$12.21 lower than Chico for the office setting.
Nebraska
Nebraska · Q4166
Office
$117.46
Facility
Unavailable
$22.01 lower than Chico for the office setting.
New Hampshire
New Hampshire · Q4166
Office
$132.47
Facility
Unavailable
$7.00 lower than Chico for the office setting.
Northern Nj
New Jersey · Q4166
Office
$147.62
Facility
Unavailable
$8.15 higher than Chico for the office setting.
Rest Of New Jersey
New Jersey · Q4166
Office
$138.97
Facility
Unavailable
$0.50 lower than Chico for the office setting.
New Mexico
New Mexico · Q4166
Office
$116.70
Facility
Unavailable
$22.77 lower than Chico for the office setting.
Nevada**
Nevada · Q4166
Office
$127.38
Facility
Unavailable
$12.09 lower than Chico for the office setting.
Nyc Suburbs/Long Island
New York · Q4166
Office
$151.31
Facility
Unavailable
$11.84 higher than Chico for the office setting.
Poughkpsie/N Nyc Suburbs
New York · Q4166
Office
$139.35
Facility
Unavailable
$0.12 lower than Chico for the office setting.
Queens
New York · Q4166
Office
$150.42
Facility
Unavailable
$10.95 higher than Chico for the office setting.
Rest Of New York
New York · Q4166
Office
$120.89
Facility
Unavailable
$18.58 lower than Chico for the office setting.
Ohio
Ohio · Q4166
Office
$116.19
Facility
Unavailable
$23.28 lower than Chico for the office setting.
Oklahoma
Oklahoma · Q4166
Office
$113.64
Facility
Unavailable
$25.83 lower than Chico for the office setting.
Portland
Oregon · Q4166
Office
$141.38
Facility
Unavailable
$1.91 higher than Chico for the office setting.
Rest Of Oregon
Oregon · Q4166
Office
$126.75
Facility
Unavailable
$12.72 lower than Chico for the office setting.
Metropolitan Philadelphia
Pennsylvania · Q4166
Office
$132.47
Facility
Unavailable
$7.00 lower than Chico for the office setting.
Rest Of Pennsylvania
Pennsylvania · Q4166
Office
$116.82
Facility
Unavailable
$22.65 lower than Chico for the office setting.
Puerto Rico
Puerto Rico · Q4166
Office
$128.66
Facility
Unavailable
$10.81 lower than Chico for the office setting.
Rhode Island
Rhode Island · Q4166
Office
$131.46
Facility
Unavailable
$8.01 lower than Chico for the office setting.
South Carolina
South Carolina · Q4166
Office
$117.59
Facility
Unavailable
$21.88 lower than Chico for the office setting.
South Dakota**
South Dakota · Q4166
Office
$127.26
Facility
Unavailable
$12.21 lower than Chico for the office setting.
Tennessee
Tennessee · Q4166
Office
$115.68
Facility
Unavailable
$23.79 lower than Chico for the office setting.
Austin
Texas · Q4166
Office
$134.64
Facility
Unavailable
$4.83 lower than Chico for the office setting.
Beaumont
Texas · Q4166
Office
$115.80
Facility
Unavailable
$23.67 lower than Chico for the office setting.
Brazoria
Texas · Q4166
Office
$126.11
Facility
Unavailable
$13.36 lower than Chico for the office setting.
Dallas
Texas · Q4166
Office
$126.75
Facility
Unavailable
$12.72 lower than Chico for the office setting.
Fort Worth
Texas · Q4166
Office
$125.48
Facility
Unavailable
$13.99 lower than Chico for the office setting.
Galveston
Texas · Q4166
Office
$126.37
Facility
Unavailable
$13.10 lower than Chico for the office setting.
Houston
Texas · Q4166
Office
$126.37
Facility
Unavailable
$13.10 lower than Chico for the office setting.
Rest Of Texas
Texas · Q4166
Office
$120.77
Facility
Unavailable
$18.70 lower than Chico for the office setting.
Utah
Utah · Q4166
Office
$119.62
Facility
Unavailable
$19.85 lower than Chico for the office setting.
Virginia
Virginia · Q4166
Office
$125.09
Facility
Unavailable
$14.38 lower than Chico for the office setting.
Virgin Islands
United States Virgin Islands · Q4166
Office
$128.66
Facility
Unavailable
$10.81 lower than Chico for the office setting.
Vermont
Vermont · Q4166
Office
$125.98
Facility
Unavailable
$13.49 lower than Chico for the office setting.
Rest Of Washington
Washington · Q4166
Office
$134.00
Facility
Unavailable
$5.47 lower than Chico for the office setting.
Seattle (King Cnty)
Washington · Q4166
Office
$156.14
Facility
Unavailable
$16.67 higher than Chico for the office setting.
Wisconsin
Wisconsin · Q4166
Office
$121.91
Facility
Unavailable
$17.56 lower than Chico for the office setting.
West Virginia
West Virginia · Q4166
Office
$110.59
Facility
Unavailable
$28.88 lower than Chico for the office setting.
Wyoming**
Wyoming · Q4166
Office
$127.26
Facility
Unavailable
$12.21 lower than Chico for the office setting.
See how rates vary across the country
Q4166 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for Q4166 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$153.42
$139.47 × 110% = $153.42
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for Q4166 in Chico.
PPRRVU2026_Oct_nonQPP.csv
18,259
- Code
- Q4166
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.017 | 0.0000 |
| Practice expense | 3.81 | × 1.096 | 4.1758 |
| Malpractice | 0.00 | × 0.536 | 0.0000 |
| Total RVUs | 4.1758 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Chico$139.47
Open Q4166 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1.017 |
| Practice expense | 3.81 | 1.096 |
| Malpractice | 0 | 0.536 |
(0 × 1.017 + 3.81 × 1.096 + 0 × 0.536) × $33.4009 = $139.47
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
Q4166 · Office / nonfacility
$139.47
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
No ratechanged to$139.47
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: No rate
Held through RVU25B, RVU25C, RVU25D.
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $139.47 | Not available in this setting | RVU26D |
| 2026-07-01 | $139.47 | Not available in this setting | RVU26C |
| 2026-04-01 | $139.47 | Not available in this setting | RVU26B |
| 2026-01-01 | $139.47 | Not available in this setting | RVU26A |
| 2025-10-01 | Separate payment rules apply | Separate payment rules apply | RVU25D |
| 2025-07-01 | Separate payment rules apply | Separate payment rules apply | RVU25C |
| 2025-04-01 | Separate payment rules apply | Separate payment rules apply | RVU25B |
| 2025-01-01 | Separate payment rules apply | Separate payment rules apply | RVU25A |
Q4166 billing questions
When is Q4166 reported instead of another wound product code?
Use Q4166 when the material furnished is Cytal. Other wound matrices have their own HCPCS codes, even when they are applied to a similar wound.
Can Q4166 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure; it is paid within that procedure's global period.
Is the wound application included in Q4166?
Q4166 reports the Cytal material by area, while the primary wound application procedure reports the clinician's application service. Document both the product amount and the application performed.
What supports the number of units?
Document the Cytal quantity used in square centimeters, along with the wound site and product identity. The code is measured by area, not by wound count or time.
Does Q4166 include a professional interpretation?
CMS classifies Q4166 as technical-component-only and assigns interpretation to a separate code. Q4166 itself reports the Cytal material.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
