HCPCS Q4398: Skin substituteMedicare rate & RVUs in Alaska

Q4398 reports Summit AC skin-substitute material by square centimeter when supplied with a primary wound procedure that applies the product.

CMS RVU26DEffective Oct 1, 20261 payment locality

Medicare pays $135.53 for Q4398 in the office in Alaska (Alaska*). Which amount applies depends on the service address.

$135.53Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open Q4398 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Alaska
  2. What Q4398 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What Q4398 covers

Q4398 identifies Summit AC, a skin-substitute product reported by the square centimeter. It represents the product material used in wound care, not the wound-preparation or application work itself. It is reported when a clinician applies Summit AC during a primary wound procedure, such as in an office or hospital outpatient setting. The record should identify the product and the wound treated.

Report Q4398 only with a primary procedure; it is an add-on, not a stand-alone service. Units follow the square-centimeter measure reported, so documentation should support the amount applied and link it to the wound and application encounter. CMS classifies this as a technical-component-only code, with interpretation covered by a separate code. Payment falls within the primary procedure’s global period. Keep Summit AC distinct from other Summit formulations and other separately coded skin-substitute products, even when they are used for similar wound-care needs.

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.

Q4398 in Alaska*

Q4398 office and facility rates by payment locality
Payment localityOfficeFacility
Alaska*$135.53Unavailable

How the Q4398 rate is calculated

Each of Q4398’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 · Q4398

RVUs × geographic indexes × conversion factor

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense3.81

3.81 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

3.8100

Conversion factor

$33.4009

Medicare rate

$127.26

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for Q4398

The CMS indicators that decide how Q4398 is paid alongside other services.

CMS payment indicators · Q4398

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.

Q4398 compared with similar codes

Compare codes · National

4 codes, side by side

  • Q4398

    Skin substitute0 wRVU

    $127.26

  • Q4397

    Not on the physician fee schedule0 wRVU

    $127.26+$0.00

  • Q4399

    Wound product0 wRVU

    $127.26+$0.00

  • Q4393

    Wound graft0 wRVU

    $127.26+$0.00

How to choose

Q4397Summit aaa per sq cm
Q4397 identifies Summit AAA, not Summit AC. Choose the code that matches the product used.
Q4399Wound product
Q4399 identifies Summit FX. Q4398 is specific to Summit AC.
Q4393Wound graft
Q4393 identifies Surgraft AC rather than Summit AC. The product applied determines which code to report.

Q4398 billing questions

Can Q4398 be billed by itself?

No. CMS identifies Q4398 as an add-on code that must be billed with a primary procedure.

How should units be supported?

Document the Summit AC product used and the square-centimeter amount applied to the wound during the primary procedure.

Does Q4398 include interpretation?

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

How does the primary procedure affect payment?

Q4398 is paid within the primary procedure’s global period, rather than as a separate service outside that period.

Should Q4398 be used for another Summit product?

Use Q4398 for Summit AC specifically. Summit AAA and Summit FX have distinct codes, Q4397 and Q4399.

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 Q4398PPRRVU2026_Oct_nonQPP.csv, line 18,483 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)

Open CMS sourceHow we calculate rates

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