HCPCS Q4116: Dermal matrixMedicare rate & RVUs in Delaware
Q4116 identifies AlloDerm acellular dermal matrix used in wound coverage or soft-tissue reconstruction, reported with the related primary procedure.
Medicare pays $125.73 for Q4116 in the office in Delaware (Delaware). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What Q4116 covers
AlloDerm is a human-derived acellular dermal matrix used as a tissue scaffold in wound coverage and soft-tissue reconstruction. It may be placed by surgeons or wound-care clinicians in settings such as outpatient wound treatment or reconstructive surgery. Q4116 identifies the product, not the work of preparing the site or placing the matrix; the applicable procedure is reported separately. The code is reported by square centimeter, so the documented product area—not the number of pieces alone—supports the units billed.
Select Q4116 only when the product used is AlloDerm, rather than another skin substitute or dermal matrix. The record should identify the product, the treated site, the area used, and the primary procedure. CMS classifies this as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. It is technical-component-only; a separate code covers interpretation. CMS assigns no physician work to Q4116, with payment associated with practice expense.
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.
Q4116 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $125.73 | Unavailable |
How the Q4116 rate is calculated
Each of Q4116’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 · Q4116
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 Q4116
The CMS indicators that decide how Q4116 is paid alongside other services.
CMS payment indicators · Q4116
Dermal matrix
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4116 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4115Skin substitute
- Q4115 identifies AlloSkin, while Q4116 identifies AlloDerm. Choose the code matching the product documented as used.
- Q4107GraftJacket
- Q4107 identifies GraftJacket rather than AlloDerm. These are separate product codes even when used for similar dermal-matrix needs.
- Q4122Wound matrix
- Q4122 identifies DermACELL, not AlloDerm. Product identity determines which supply code applies.
Q4116 billing questions
Does Q4116 report the AlloDerm placement procedure?
No. Q4116 reports the AlloDerm product; report the applicable primary procedure for placing it separately. CMS identifies Q4116 as an add-on code that must accompany a primary procedure.
How should the units be counted?
Report units based on the square centimeters of AlloDerm used. Document the treated area and the amount of product applied or implanted.
What documentation supports Q4116?
Record the AlloDerm product used, the treated site, the product area, and the associated primary procedure. Product packaging or other product records can help substantiate the material and quantity.
Is interpretation included in Q4116?
No. CMS classifies Q4116 as technical-component-only and identifies a separate code for interpretation.
Can Q4116 be billed by itself?
No. Under the CMS rule supplied for this code, it is billed only with a primary procedure and is paid within that procedure’s global period.
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
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