$144.69
Q4345 identifies Matrix HD allograft, while Q4346 identifies Shelter DM matrix. Report the product code matching the material furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4346 Wound matrix Medicare reimbursement rates in Guam
Reports Shelter DM matrix furnished for wound treatment, measured by the square centimeter and billed with the applicable skin-substitute application procedure. Compare Q4346 office and facility rates across CMS payment localities in Guam.
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 Q4346 in Guam?
Guam 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
$144.69
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Skin substitute
About Q4346: Shelter DM wound matrix supply
Reports Shelter DM matrix furnished for wound treatment, measured by the square centimeter and billed with the applicable skin-substitute application procedure.
Q4346 identifies Shelter DM matrix furnished for wound treatment, with the reported quantity measured by the square centimeter. The product is used as part of a skin-substitute application to a wound. The treating clinician performs the application; the Q-code represents the material rather than the wound assessment or application service. The record should identify the treated wound and the Shelter DM product used.
Report Q4346 with the primary application procedure, not by itself. Choose the application code based on the treated body site and wound area, and support the quantity with documentation of the matrix used. CMS treats this as an add-on code paid within the primary procedure’s global period. CMS also classifies it as technical-component-only, with a separate code covering interpretation.
CMS billing rules for Q4346
- 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.
Q4346 compared with similar codes
Office rates for Guam, from the same CMS release.
$144.69
Q4347 identifies Rampart DL matrix rather than Shelter DM. The shared per-square-centimeter unit does not make the product codes interchangeable.
$338.94
15273 is an application procedure selected for specified sites such as the face, scalp, hands, or feet; Q4346 identifies the Shelter DM product.
Compare Q4346 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
Hawaii, Guam →
Office / nonfacility
$144.69
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 Q4346 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
18,433
- Code
- Q4346
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 1.137 | 4.3320 |
| Malpractice | 0.00 | × 0.579 | 0.0000 |
| Total RVUs | 4.3320 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$144.69
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 1.137 |
| Malpractice | 0 | 0.579 |
(0 × 1 + 3.81 × 1.137 + 0 × 0.579) × $33.4009 = $144.69
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.
Q4346 billing questions
Can Q4346 be reported by itself?
No. CMS designates it as an add-on code, so report it with the applicable primary skin-substitute application procedure.
How is the quantity determined?
The code is measured per square centimeter. Document the Shelter DM product and the amount used for the treated wound.
Which application code should accompany Q4346?
Select the primary application procedure according to the treated body site and wound area. For example, 15271 is for application to the trunk, arms, or legs, while 15273 is for specified other sites such as the face, scalp, hands, or feet.
Does Q4346 include the application service?
No. Q4346 identifies the Shelter DM material; report the applicable primary procedure for the application.
How does CMS classify its components?
CMS identifies Q4346 as technical-component-only; a separate code covers 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 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.
18,430Q4343,,Dermacyte ac matrx 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
18,431Q4344,,"Tri membrane wrap, 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
18,432Q4345,,Matrix hd allogrft 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
18,433Q4346,,Shelter dm matrix 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
18,434Q4347,,Rampart dl matrix 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
18,435Q4348,,Sentry sl matrix 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
18,436Q4349,,Mantle dl matrix 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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014