$125.73
Q4437 identifies Revival AC; Q4438 identifies Pretect. Select the product code matching the product supplied.
On this page
CMS RVU26D · Effective 2026-10-01
Q4438 Skin substitute Medicare reimbursement rates in Delaware
Q4438 reports Pretect by square centimeter as a wound-covering skin substitute product supplied with a primary wound procedure. Compare Q4438 office and facility rates across CMS payment localities in Delaware.
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 Q4438 in Delaware?
Delaware 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
$125.73
1 of 1 localities have a supported rate.
Payment area: Delaware
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 product
About Q4438: Pretect wound product per square centimeter
Q4438 reports Pretect by square centimeter as a wound-covering skin substitute product supplied with a primary wound procedure.
Q4438 identifies the Pretect product supplied for wound coverage, measured by square centimeter. Skin-substitute products are used by wound-care clinicians, podiatrists, and surgeons to cover prepared wound beds, including chronic diabetic foot and venous leg ulcers. This code represents the product, not the clinician’s wound preparation or application service.
Report Q4438 only with a primary procedure; CMS treats it as an add-on and pays it within that procedure’s global period. Use the documented Pretect product and square-centimeter quantity to support the units reported, and report the primary procedure separately. CMS classifies Q4438 as technical-component-only; a separate code covers interpretation. The record should identify the product and the wound area and quantity used so the product billing can be reconciled with the primary service.
CMS billing rules for Q4438
- 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.
Q4438 compared with similar codes
Office rates for Delaware, from the same CMS release.
$125.73
Q4439 identifies Instagraft, not Pretect. Both descriptors measure a named product by square centimeter.
Q4431
No office ratePma skin substitute, nos
Q4431 is a nonspecific PMA skin-substitute category. Q4438 identifies Pretect specifically.
Q4432
No office rate510(k) skin subs, nos
Q4432 is a nonspecific 510(k) skin-substitute category. Q4438 identifies Pretect specifically.
Compare Q4438 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
Delaware →
Office / nonfacility
$125.73
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 Q4438 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
18,521
- Code
- Q4438
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.005 | 0.0000 |
| Practice expense | 3.81 | × 0.988 | 3.7643 |
| Malpractice | 0.00 | × 0.899 | 0.0000 |
| Total RVUs | 3.7643 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$125.73
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1.005 |
| Practice expense | 3.81 | 0.988 |
| Malpractice | 0 | 0.899 |
(0 × 1.005 + 3.81 × 0.988 + 0 × 0.899) × $33.4009 = $125.73
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.
Q4438 billing questions
Does Q4438 report application of the product?
No. Q4438 reports the Pretect product per square centimeter; the primary wound procedure reports the application service.
Can Q4438 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
How are units determined?
The descriptor is per square centimeter. Document the Pretect quantity and wound area used to support the reported units.
Is interpretation included in Q4438?
No. CMS classifies Q4438 as technical-component-only and identifies a separate code for interpretation.
What documentation supports Q4438?
Record the product as Pretect, the square-centimeter quantity used, the treated wound area, and the associated primary procedure.
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.
18,518Q4435,,Renati membrane 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
18,519Q4436,,Renati ac membrane 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
18,520Q4437,,Revival ac 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
18,521Q4438,,Pretect 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
18,522Q4439,,Instagraft 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
18,523Q4440,,Curamatrix 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
18,524Q5001,,Hospice or home hlth in home,E,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503