$111.35
Use Q4195 when the documented product is PuraPly. Use Q4197 only when it is PuraPly XT.
On this page
CMS RVU26D · Effective 2026-10-01
Q4197 PuraPly XT Medicare reimbursement rates in Alabama
Reports each square centimeter of PuraPly XT wound matrix used during a wound-covering procedure, alongside the applicable primary procedure code. Compare Q4197 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for Q4197 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$111.35
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound care
About Q4197: PuraPly XT wound matrix, per square centimeter
Reports each square centimeter of PuraPly XT wound matrix used during a wound-covering procedure, alongside the applicable primary procedure code.
PuraPly XT is a wound matrix placed over a prepared wound to provide a protective covering. Q4197 identifies the specific product rather than the clinician’s work of applying it. Wound-care clinicians may use the matrix during treatment of a difficult-to-heal wound, such as a lower-leg ulcer, in an office or facility setting. The application procedure is identified separately according to the wound site and the procedure performed.
Report Q4197 in square-centimeter units for PuraPly XT, supported by the product record and the amount used. Confirm the product name: standard PuraPly and PuraPly AM have different codes. CMS designates Q4197 as an add-on code, so it is billed only with a primary procedure and is paid within that procedure’s global period. CMS also classifies it as technical-component-only; a separate code covers interpretation. Q4197 therefore represents the product component, not the professional work of applying the matrix or an interpretation service.
CMS billing rules for Q4197
- 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.
Q4197 compared with similar codes
Office rates for Alabama, from the same CMS release.
$111.35
Use Q4196 for PuraPly AM. The AM and XT product names identify different matrix codes.
$142.17
Q4197 identifies the PuraPly XT matrix by square centimeter; 15271 describes application to a qualifying wound on the trunk, arms, or legs. They represent different parts of the encounter.
Compare Q4197 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$111.35
Facility
Unavailable
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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 Q4197 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
18,289
- Code
- Q4197
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.875 | 3.3338 |
| Malpractice | 0.00 | × 0.566 | 0.0000 |
| Total RVUs | 3.3338 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$111.35
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.875 |
| Malpractice | 0 | 0.566 |
(0 × 1 + 3.81 × 0.875 + 0 × 0.566) × $33.4009 = $111.35
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.
Q4197 billing questions
How is Q4197 different from Q4195 and Q4196?
Q4197 identifies PuraPly XT. Q4195 identifies PuraPly, and Q4196 identifies PuraPly AM; select the code that matches the documented product.
Can Q4197 be reported without an application procedure?
No. CMS designates Q4197 as an add-on code that is billed with a primary procedure and paid within that procedure’s global period.
What supports the number of Q4197 units?
The units are based on square centimeters of PuraPly XT. The treatment record should identify the product and document the amount used.
Does Q4197 include the clinician’s work of applying the matrix?
No. Q4197 identifies the PuraPly XT product; the primary procedure describes the application work.
Does Q4197 cover interpretation?
No. CMS classifies Q4197 as technical-component-only and assigns interpretation to a separate 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 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.
18,286Q4194,,Novachor 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
18,287Q4195,,Puraply 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
18,288Q4196,,Puraply am 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
18,289Q4197,,Puraply xt 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
18,290Q4198,,Genesis amnio membrane 1sqcm,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
18,291Q4199,,"Cygnus matrix, per 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
18,292Q4200,,Skin te 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
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515