HCPCS Q4426: Skin substituteMedicare rate & RVUs in Florida
Reports DermBnd TL+ or TLX skin substitute by square centimeter when the product is supplied for application to a wound with a primary procedure.
Medicare pays $121.66–$132.47 for Q4426 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 Q4426 covers
Q4426 identifies the DermBnd TL+ or TLX skin substitute product in square-centimeter units. It represents the product supplied for wound coverage, not the clinician’s work applying it. The product may be used in wound care settings where a clinician applies a skin substitute to a wound; the application itself is reported separately with the procedure code selected for the wound’s site and treated area.
Report Q4426 only with a primary procedure, and count the product area in square centimeters as supported by the record. Documentation should identify the product, the wound treated, and the quantity used. CMS treats this as an add-on code paid within the primary procedure’s global period. It is classified as technical-component-only; a separate code covers interpretation. The product code does not replace the application procedure code, and the two code selections serve different purposes.
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 Q4426 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 Q4426 rate is calculated
Each of Q4426’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 · Q4426
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 Q4426
The CMS indicators that decide how Q4426 is paid alongside other services.
CMS payment indicators · Q4426
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. |
Q4426 compared with similar codes
Compare codes
Q4426 vs Q4427 vs Q4428 vs 15271: national Medicare rates
Swap in your local Medicare rate.
How to choose
- Q4427Skin substitute
- Q4427 identifies a different DermBnd product designation. Use the code matching the product supplied, not simply another DermBnd code.
- Q4428DermBnd skin substitute
- Q4428 represents a different DermBnd product designation from TL+ or TLX. Match the product code to the product documented.
- 15271Skin substitute graft
- 15271 reports the application procedure for qualifying wounds on the trunk or extremities; Q4426 reports the DermBnd product by square centimeter.
Q4426 billing questions
Is Q4426 the wound application procedure?
No. Q4426 reports the DermBnd TL+ or TLX product by square centimeter. Report the appropriate wound application procedure separately as the primary service.
Can Q4426 be billed by itself?
No. CMS identifies Q4426 as an add-on code that must be billed with a primary procedure.
How should the units be determined?
Use the documented square centimeters of DermBnd TL+ or TLX product supplied for the wound. The record should support the product and quantity reported.
Which code should be used for the application?
Select the primary skin-substitute application code based on the wound’s site and treated area. Q4426 identifies the product, not the application work.
How does the global-period rule affect Q4426?
CMS pays this add-on within the global period of its primary procedure. Report it with that procedure rather than as a stand-alone service.
Does Q4426 include interpretation?
No. CMS classifies Q4426 as technical-component-only, with a separate code covering interpretation.
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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