HCPCS Q4398: Skin substituteMedicare rate & RVUs in Florida
Q4398 reports Summit AC skin-substitute material by square centimeter when supplied with a primary wound procedure that applies the product.
Medicare pays $121.66–$132.47 for Q4398 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 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.
Where Q4398 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 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
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 Q4398
The CMS indicators that decide how Q4398 is paid alongside other services.
CMS payment indicators · Q4398
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. |
Q4398 compared with similar codes
Compare codes
Q4398 vs Q4397 vs Q4399 vs Q4393: national Medicare rates
Swap in your local Medicare rate.
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
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