$156.16
Q4152 reports Dermapure product; 15271 reports application to the trunk, arms, or legs. Report both when the product and application service are furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4152 in Wyoming**
Office / nonfacility
$127.26
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.
Skin substitute
About Q4152: Dermapure dermal matrix supply
Reports Dermapure dermal matrix supplied for wound treatment, measured by square centimeter and billed with the primary procedure that applies it.
Q4152 represents the Dermapure biologic dermal matrix supplied for wound care; it is the product code, not the service of preparing the wound or placing the material. Clinicians may use a dermal matrix in treating wounds such as chronic ulcers. The treating physician or other qualified practitioner typically documents the wound site and dimensions and performs or oversees the application in an outpatient or facility setting.
Report the measured square centimeters of Dermapure supplied, supported by the product record and documentation of the wound area treated. Bill Q4152 only with a primary procedure; CMS treats it as an add-on and includes its payment within that procedure's global period. CMS classifies the code as technical-component-only, with interpretation covered by a separate code. Report the applicable skin-substitute application procedure separately; its selection depends on the wound site and treated area.
CMS billing rules for Q4152
- 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.
Q4152 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
$127.26
Q4153 identifies Dermavest or Plurivest, not Dermapure. Select the HCPCS code for the product actually supplied.
$127.26
Q4154 identifies Biovance, while Q4152 identifies Dermapure. The square-centimeter unit does not make these product codes interchangeable.
The same code, a different location
How does Wyoming** compare?
Q4152 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
$127.26
$23.29 higher than Wyoming**
$149.91
$22.65 higher than Wyoming**
$132.47
$5.21 higher than Wyoming**
$127.89
$0.63 higher than Wyoming**
$147.87
$20.61 higher than Wyoming**
$135.53
$8.27 higher than Wyoming**
Other payment areas listed in Wyoming 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, Q4152 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
Alabama
Alabama · Q4152
Office
$111.35
Facility
Unavailable
$15.91 lower than Wyoming** for the office setting.
Arkansas
Arkansas · Q4152
Office
$109.31
Facility
Unavailable
$17.95 lower than Wyoming** for the office setting.
Arizona
Arizona · Q4152
Office
$123.31
Facility
Unavailable
$3.95 lower than Wyoming** for the office setting.
Bakersfield
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Chico
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
El Centro
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Fresno
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Hanford-Corcoran
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Madera
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Merced
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Modesto
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Napa
California · Q4152
Office
$167.73
Facility
Unavailable
$40.47 higher than Wyoming** for the office setting.
Oxnard-Thousand Oaks-Ventura
California · Q4152
Office
$150.42
Facility
Unavailable
$23.16 higher than Wyoming** for the office setting.
Redding
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Rest Of California
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Riverside-San Bernardino-Ontario
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Sacramento-Roseville-Folsom
California · Q4152
Office
$148.00
Facility
Unavailable
$20.74 higher than Wyoming** for the office setting.
Salinas
California · Q4152
Office
$147.49
Facility
Unavailable
$20.23 higher than Wyoming** for the office setting.
San Diego-Chula Vista-Carlsbad
California · Q4152
Office
$152.20
Facility
Unavailable
$24.94 higher than Wyoming** for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · Q4152
Office
$179.43
Facility
Unavailable
$52.17 higher than Wyoming** for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · Q4152
Office
$179.43
Facility
Unavailable
$52.17 higher than Wyoming** for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · Q4152
Office
$183.51
Facility
Unavailable
$56.25 higher than Wyoming** for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · Q4152
Office
$183.51
Facility
Unavailable
$56.25 higher than Wyoming** for the office setting.
San Luis Obispo-Paso Robles
California · Q4152
Office
$144.95
Facility
Unavailable
$17.69 higher than Wyoming** for the office setting.
Santa Cruz-Watsonville
California · Q4152
Office
$154.62
Facility
Unavailable
$27.36 higher than Wyoming** for the office setting.
Santa Maria-Santa Barbara
California · Q4152
Office
$148.38
Facility
Unavailable
$21.12 higher than Wyoming** for the office setting.
Santa Rosa-Petaluma
California · Q4152
Office
$156.27
Facility
Unavailable
$29.01 higher than Wyoming** for the office setting.
Stockton
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Vallejo
California · Q4152
Office
$167.73
Facility
Unavailable
$40.47 higher than Wyoming** for the office setting.
Visalia
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Yuba City
California · Q4152
Office
$139.47
Facility
Unavailable
$12.21 higher than Wyoming** for the office setting.
Colorado
Colorado · Q4152
Office
$135.40
Facility
Unavailable
$8.14 higher than Wyoming** for the office setting.
Connecticut
Connecticut · Q4152
Office
$137.06
Facility
Unavailable
$9.80 higher than Wyoming** for the office setting.
Delaware
Delaware · Q4152
Office
$125.73
Facility
Unavailable
$1.53 lower than Wyoming** for the office setting.
Fort Lauderdale
Florida · Q4152
Office
$128.91
Facility
Unavailable
$1.65 higher than Wyoming** for the office setting.
Rest Of Florida
Florida · Q4152
Office
$121.66
Facility
Unavailable
$5.60 lower than Wyoming** for the office setting.
Atlanta
Georgia · Q4152
Office
$129.29
Facility
Unavailable
$2.03 higher than Wyoming** for the office setting.
Rest Of Georgia
Georgia · Q4152
Office
$113.51
Facility
Unavailable
$13.75 lower than Wyoming** for the office setting.
Hawaii, Guam
Hawaii · Q4152
Office
$144.69
Facility
Unavailable
$17.43 higher than Wyoming** for the office setting.
Iowa
Iowa · Q4152
Office
$116.44
Facility
Unavailable
$10.82 lower than Wyoming** for the office setting.
Idaho
Idaho · Q4152
Office
$117.08
Facility
Unavailable
$10.18 lower than Wyoming** for the office setting.
East St. Louis
Illinois · Q4152
Office
$117.08
Facility
Unavailable
$10.18 lower than Wyoming** for the office setting.
Rest Of Illinois
Illinois · Q4152
Office
$116.19
Facility
Unavailable
$11.07 lower than Wyoming** for the office setting.
Suburban Chicago
Illinois · Q4152
Office
$130.69
Facility
Unavailable
$3.43 higher than Wyoming** for the office setting.
Indiana
Indiana · Q4152
Office
$117.97
Facility
Unavailable
$9.29 lower than Wyoming** for the office setting.
Kansas
Kansas · Q4152
Office
$115.04
Facility
Unavailable
$12.22 lower than Wyoming** for the office setting.
Kentucky
Kentucky · Q4152
Office
$113.13
Facility
Unavailable
$14.13 lower than Wyoming** for the office setting.
New Orleans
Louisiana · Q4152
Office
$119.75
Facility
Unavailable
$7.51 lower than Wyoming** for the office setting.
Rest Of Louisiana
Louisiana · Q4152
Office
$112.62
Facility
Unavailable
$14.64 lower than Wyoming** for the office setting.
Metropolitan Boston
Massachusetts · Q4152
Office
$151.95
Facility
Unavailable
$24.69 higher than Wyoming** for the office setting.
Rest Of Massachusetts
Massachusetts · Q4152
Office
$134.00
Facility
Unavailable
$6.74 higher than Wyoming** for the office setting.
Baltimore/Surr. Cntys
Maryland · Q4152
Office
$136.55
Facility
Unavailable
$9.29 higher than Wyoming** for the office setting.
Rest Of Maryland
Maryland · Q4152
Office
$128.78
Facility
Unavailable
$1.52 higher than Wyoming** for the office setting.
Rest Of Maine
Maine · Q4152
Office
$117.08
Facility
Unavailable
$10.18 lower than Wyoming** for the office setting.
Southern Maine
Maine · Q4152
Office
$126.11
Facility
Unavailable
$1.15 lower than Wyoming** for the office setting.
Detroit
Michigan · Q4152
Office
$122.80
Facility
Unavailable
$4.46 lower than Wyoming** for the office setting.
Rest Of Michigan
Michigan · Q4152
Office
$116.19
Facility
Unavailable
$11.07 lower than Wyoming** for the office setting.
Minnesota
Minnesota · Q4152
Office
$130.95
Facility
Unavailable
$3.69 higher than Wyoming** for the office setting.
Metropolitan Kansas City
Missouri · Q4152
Office
$119.49
Facility
Unavailable
$7.77 lower than Wyoming** for the office setting.
Metropolitan St. Louis
Missouri · Q4152
Office
$121.15
Facility
Unavailable
$6.11 lower than Wyoming** for the office setting.
Rest Of Missouri
Missouri · Q4152
Office
$109.70
Facility
Unavailable
$17.56 lower than Wyoming** for the office setting.
Mississippi
Mississippi · Q4152
Office
$109.57
Facility
Unavailable
$17.69 lower than Wyoming** for the office setting.
Montana**
Montana · Q4152
Office
$127.26
Facility
Unavailable
The same base rate than Wyoming** for the office setting.
North Carolina
North Carolina · Q4152
Office
$118.73
Facility
Unavailable
$8.53 lower than Wyoming** for the office setting.
North Dakota**
North Dakota · Q4152
Office
$127.26
Facility
Unavailable
The same base rate than Wyoming** for the office setting.
Nebraska
Nebraska · Q4152
Office
$117.46
Facility
Unavailable
$9.80 lower than Wyoming** for the office setting.
New Hampshire
New Hampshire · Q4152
Office
$132.47
Facility
Unavailable
$5.21 higher than Wyoming** for the office setting.
Northern Nj
New Jersey · Q4152
Office
$147.62
Facility
Unavailable
$20.36 higher than Wyoming** for the office setting.
Rest Of New Jersey
New Jersey · Q4152
Office
$138.97
Facility
Unavailable
$11.71 higher than Wyoming** for the office setting.
New Mexico
New Mexico · Q4152
Office
$116.70
Facility
Unavailable
$10.56 lower than Wyoming** for the office setting.
Nevada**
Nevada · Q4152
Office
$127.38
Facility
Unavailable
$0.12 higher than Wyoming** for the office setting.
Nyc Suburbs/Long Island
New York · Q4152
Office
$151.31
Facility
Unavailable
$24.05 higher than Wyoming** for the office setting.
Poughkpsie/N Nyc Suburbs
New York · Q4152
Office
$139.35
Facility
Unavailable
$12.09 higher than Wyoming** for the office setting.
Queens
New York · Q4152
Office
$150.42
Facility
Unavailable
$23.16 higher than Wyoming** for the office setting.
Rest Of New York
New York · Q4152
Office
$120.89
Facility
Unavailable
$6.37 lower than Wyoming** for the office setting.
Ohio
Ohio · Q4152
Office
$116.19
Facility
Unavailable
$11.07 lower than Wyoming** for the office setting.
Oklahoma
Oklahoma · Q4152
Office
$113.64
Facility
Unavailable
$13.62 lower than Wyoming** for the office setting.
Portland
Oregon · Q4152
Office
$141.38
Facility
Unavailable
$14.12 higher than Wyoming** for the office setting.
Rest Of Oregon
Oregon · Q4152
Office
$126.75
Facility
Unavailable
$0.51 lower than Wyoming** for the office setting.
Metropolitan Philadelphia
Pennsylvania · Q4152
Office
$132.47
Facility
Unavailable
$5.21 higher than Wyoming** for the office setting.
Rest Of Pennsylvania
Pennsylvania · Q4152
Office
$116.82
Facility
Unavailable
$10.44 lower than Wyoming** for the office setting.
Puerto Rico
Puerto Rico · Q4152
Office
$128.66
Facility
Unavailable
$1.40 higher than Wyoming** for the office setting.
Rhode Island
Rhode Island · Q4152
Office
$131.46
Facility
Unavailable
$4.20 higher than Wyoming** for the office setting.
South Carolina
South Carolina · Q4152
Office
$117.59
Facility
Unavailable
$9.67 lower than Wyoming** for the office setting.
South Dakota**
South Dakota · Q4152
Office
$127.26
Facility
Unavailable
The same base rate than Wyoming** for the office setting.
Tennessee
Tennessee · Q4152
Office
$115.68
Facility
Unavailable
$11.58 lower than Wyoming** for the office setting.
Austin
Texas · Q4152
Office
$134.64
Facility
Unavailable
$7.38 higher than Wyoming** for the office setting.
Beaumont
Texas · Q4152
Office
$115.80
Facility
Unavailable
$11.46 lower than Wyoming** for the office setting.
Brazoria
Texas · Q4152
Office
$126.11
Facility
Unavailable
$1.15 lower than Wyoming** for the office setting.
Dallas
Texas · Q4152
Office
$126.75
Facility
Unavailable
$0.51 lower than Wyoming** for the office setting.
Fort Worth
Texas · Q4152
Office
$125.48
Facility
Unavailable
$1.78 lower than Wyoming** for the office setting.
Galveston
Texas · Q4152
Office
$126.37
Facility
Unavailable
$0.89 lower than Wyoming** for the office setting.
Houston
Texas · Q4152
Office
$126.37
Facility
Unavailable
$0.89 lower than Wyoming** for the office setting.
Rest Of Texas
Texas · Q4152
Office
$120.77
Facility
Unavailable
$6.49 lower than Wyoming** for the office setting.
Utah
Utah · Q4152
Office
$119.62
Facility
Unavailable
$7.64 lower than Wyoming** for the office setting.
Virginia
Virginia · Q4152
Office
$125.09
Facility
Unavailable
$2.17 lower than Wyoming** for the office setting.
Virgin Islands
United States Virgin Islands · Q4152
Office
$128.66
Facility
Unavailable
$1.40 higher than Wyoming** for the office setting.
Vermont
Vermont · Q4152
Office
$125.98
Facility
Unavailable
$1.28 lower than Wyoming** for the office setting.
Rest Of Washington
Washington · Q4152
Office
$134.00
Facility
Unavailable
$6.74 higher than Wyoming** for the office setting.
Seattle (King Cnty)
Washington · Q4152
Office
$156.14
Facility
Unavailable
$28.88 higher than Wyoming** for the office setting.
Wisconsin
Wisconsin · Q4152
Office
$121.91
Facility
Unavailable
$5.35 lower than Wyoming** for the office setting.
West Virginia
West Virginia · Q4152
Office
$110.59
Facility
Unavailable
$16.67 lower than Wyoming** for the office setting.
See how rates vary across the country
Q4152 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Q4152 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$139.99
$127.26 × 110% = $139.99
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 Q4152 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
18,245
- Code
- Q4152
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 1.000 | 3.8100 |
| Malpractice | 0.00 | × 0.740 | 0.0000 |
| Total RVUs | 3.8100 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$127.26
Open Q4152 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 1 |
| Malpractice | 0 | 0.74 |
(0 × 1 + 3.81 × 1 + 0 × 0.74) × $33.4009 = $127.26
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
Q4152 · Office / nonfacility
$127.26
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$127.26
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 | $127.26 | Not available in this setting | RVU26D |
| 2026-07-01 | $127.26 | Not available in this setting | RVU26C |
| 2026-04-01 | $127.26 | Not available in this setting | RVU26B |
| 2026-01-01 | $127.26 | 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 |
Q4152 billing questions
Does Q4152 report Dermapure placement?
No. Q4152 reports the Dermapure product; report the applicable skin-substitute application procedure separately.
Can Q4152 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure, and its payment falls within that procedure's global period.
How are units determined?
The code is measured per square centimeter. Document the amount of Dermapure supplied and the wound area treated to support the units reported.
Which application code should accompany Q4152?
Select the skin-substitute application procedure according to the treated body site and area. For example, 15271 is for application to the trunk, arms, or legs within its stated area range.
Does Q4152 include professional interpretation?
No. CMS identifies Q4152 as technical-component-only; a separate code covers interpretation.
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.
18,242Q4149,,"Excellagen, 0.1 cc",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,243Q4150,,Allowrap ds or dry 1 sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,244Q4151,,"Amnioband, guardian 1 sq cm",A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,245Q4152,,Dermapure 1 square cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,246Q4153,,"Dermavest, plurivest sq cm",A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,247Q4154,,Biovance 1 square cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,248Q4155,,Neoxflo or clarixflo 1 mg,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,