HCPCS Q4389: Wound matrixMedicare rate & RVUs in Delaware

Reports Neothelium 4L+ wound matrix by square centimeter when supplied for application to a wound with a separately reported primary procedure.

CMS RVU26DEffective Oct 1, 20261 payment locality

Medicare pays $125.73 for Q4389 in the office in Delaware (Delaware). Which amount applies depends on the service address.

$125.73Office (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 Q4389 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What Q4389 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 Q4389 covers

Q4389 represents the Neothelium 4L+ wound matrix product, measured by the square centimeter. It identifies the material supplied for wound coverage; it is not the clinician’s wound-preparation or application service. Wound-care physicians, podiatrists, and surgeons may use a matrix product during treatment of wounds that require coverage, with the application performed in an office, clinic, or facility setting.

Report the product code with the applicable primary procedure, not by itself. The clinical record should support the product used and the amount represented by the billed units. CMS classifies Q4389 as an add-on code, so payment is within the primary procedure’s global period. It is also technical-component-only; any separately reportable interpretation is represented by its own code rather than Q4389. The product code and the wound application service describe distinct parts of the treatment.

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.

Q4389 in Delaware

Q4389 office and facility rates by payment locality
Payment localityOfficeFacility
Delaware$125.73Unavailable

How the Q4389 rate is calculated

Each of Q4389’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 · Q4389

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 Q4389

The CMS indicators that decide how Q4389 is paid alongside other services.

CMS payment indicators · Q4389

Wound matrix

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.

Q4389 compared with similar codes

Compare codes · National

4 codes, side by side

  • Q4389

    Wound matrix0 wRVU

    $127.26

  • Q4388

    Wound product0 wRVU

    $127.26+$0.00

  • Q4387

    Skin substitute0 wRVU

    $127.26+$0.00

  • 15271

    Skin substitute graft1.46 wRVU

    $157.99+$30.73

How to choose

Q4388Wound product
Q4388 identifies Neothelium 4L; Q4389 identifies Neothelium 4L+. Match the code to the specific product supplied.
Q4387Skin substitute
Q4387 identifies Neothelium full thickness, while Q4389 identifies Neothelium 4L+. These are different product variants.
15271Skin substitute graft
15271 reports a wound application service, not the Neothelium product itself. Q4389 identifies the product and is reported with an applicable primary procedure.

Q4389 billing questions

How is Q4389 different from Q4388?

Both identify Neothelium products billed by square centimeter, but Q4389 specifies the 4L+ product, while Q4388 identifies Neothelium 4L. Select the code matching the product supplied.

Can Q4389 be billed without a wound application procedure?

No. CMS identifies Q4389 as an add-on code that must be billed with a primary procedure; it is paid within that procedure’s global period.

Is the product included in the application code?

Q4389 identifies the product, while the primary procedure represents the wound application service. Report the applicable codes together when the product is used with that procedure.

How should units be supported?

The code is measured per square centimeter. Documentation should identify Neothelium 4L+ and support the square-centimeter amount represented by the units billed.

Does Q4389 include professional interpretation?

No. CMS classifies Q4389 as technical-component-only; any separately reportable interpretation is represented by 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 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 Q4389PPRRVU2026_Oct_nonQPP.csv, line 18,474 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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