$144.69
Q4165 identifies Keramatrix or Kerasorb. Q4166 is specific to Cytal; select according to the product actually furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4166 Wound matrix Medicare reimbursement rates in Hawaii
Reports Cytal extracellular matrix material used on a wound bed, measured by area and billed with the related wound application procedure. Compare Q4166 office and facility rates across CMS payment localities in Hawaii.
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 Q4166 in Hawaii?
Hawaii 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.
Wound care supply
About Q4166: Cytal wound matrix supply
Reports Cytal extracellular matrix material used on a wound bed, measured by area and billed with the related wound application procedure.
Cytal is an extracellular matrix wound product derived from porcine urinary bladder tissue. A wound-care clinician may apply it to a prepared wound bed, including in the treatment of chronic wounds such as diabetic foot or venous leg ulcers. The product amount is reported by the square centimeter, rather than by the number of wounds or a time increment.
Report Q4166 with the primary wound application procedure for the same treatment, using documentation that identifies Cytal, the treated wound site, and the quantity applied in square centimeters. CMS classifies this as an add-on code: it must be billed with a primary procedure and is paid within that procedure's global period. CMS also identifies it as technical-component-only, with interpretation covered by a separate code rather than this line. The application service and the Cytal material are distinct reported items.
CMS billing rules for Q4166
- 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.
Q4166 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$144.69
Q4167 identifies TruSkin, not Cytal. Both are area-based wound product codes, but the product determines which code applies.
$169.04
15271 reports the wound application service for qualifying trunk or extremity sites. Q4166 reports the Cytal material and must accompany a primary procedure.
Compare Q4166 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
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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 Q4166 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
18,259
- Code
- Q4166
- 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.
Q4166 billing questions
When is Q4166 reported instead of another wound product code?
Use Q4166 when the material furnished is Cytal. Other wound matrices have their own HCPCS codes, even when they are applied to a similar wound.
Can Q4166 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure; it is paid within that procedure's global period.
Is the wound application included in Q4166?
Q4166 reports the Cytal material by area, while the primary wound application procedure reports the clinician's application service. Document both the product amount and the application performed.
What supports the number of units?
Document the Cytal quantity used in square centimeters, along with the wound site and product identity. The code is measured by area, not by wound count or time.
Does Q4166 include a professional interpretation?
CMS classifies Q4166 as technical-component-only and assigns interpretation to a separate code. Q4166 itself reports the Cytal material.
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.
18,256Q4163,,"Woundex, bioskin, 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
18,257Q4164,,"Helicoll, per square 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
18,258Q4165,,"Keramatrix, kerasorb 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
18,259Q4166,,"Cytal, per square centimeter",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
18,260Q4167,,"Truskin, per sq centimeter",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
18,261Q4168,,"Amnioband, 1 mg",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,262Q4169,,"Artacent wound, 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