HCPCS Q4203: Skin substituteMedicare rate & RVUs in Florida
Q4203 reports Derma-gide by square centimeter when the product is used with a primary wound procedure for skin substitute application.
Medicare pays $121.66–$132.47 for Q4203 in the office in Florida, from Rest Of Florida to Miami. 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 Q4203 covers
Q4203 identifies Derma-gide supplied for wound coverage, measured in 1-square-centimeter units. It is reported for the product used on a wound, not for the clinician’s wound assessment or application work. Wound care clinicians, surgeons, and podiatrists may use skin substitute products in outpatient wound settings; the record should identify Derma-gide and the treated wound area.
CMS classifies Q4203 as an add-on code: report it only with a primary procedure, and payment is included within that procedure’s global period. The quantity should correspond to the square centimeters of product used, supported by documentation of the product and treated area. CMS identifies this code as technical-component-only; a separate code covers interpretation. Q4203 has no physician work RVUs, so it represents the product’s technical portion rather than a separate professional interpretation service.
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.
Where Q4203 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$121.66 to $132.47
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $128.91 | Unavailable |
| Miami | $132.47 | Unavailable |
| Rest Of Florida | $121.66 | Unavailable |
How the Q4203 rate is calculated
Each of Q4203’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 · Q4203
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 3.81Malpractice 0.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4203
The CMS indicators that decide how Q4203 is paid alongside other services.
CMS payment indicators · Q4203
Skin substitute
| 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. |
Q4203 compared with similar codes
Compare codes
Q4203 vs Q4200 vs Q4201 vs Q4205: national Medicare rates
Swap in your local Medicare rate.
How to choose
- Q4200SkinTE
- Q4200 identifies SkinTE, while Q4203 identifies Derma-gide. Select the code for the specific product used, not simply because both are billed by square centimeter.
- Q4201Matrion
- Q4201 identifies Matrion; Q4203 identifies Derma-gide. The product name on the record distinguishes the codes.
- Q4205Membrane graft
- Q4205 describes a membrane graft or wrap product. Q4203 is specific to Derma-gide, so use the code matching the supplied product.
Q4203 billing questions
What does one unit of Q4203 represent?
One unit represents 1 square centimeter of Derma-gide. Document the amount used and the area treated.
Can Q4203 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
Which primary procedure may be reported with Q4203?
Pair it with the applicable skin substitute application procedure, such as 15271 for an eligible trunk, arm, or leg site or 15275 for an eligible face, scalp, or neck site.
How does the global-period rule affect payment?
CMS pays Q4203 within the global period of the primary procedure. It is not paid as a separate service outside that pairing.
What should the record support?
Document that Derma-gide was used, the wound treated, and the square centimeters applied. The product identity matters when distinguishing Q4203 from other skin substitute codes.
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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