HCPCS code Q4351: Wound matrix2026 Medicare rate & RVUs in Illinois
Report Enclose TL Matrix by square centimeter when this product is placed on a wound as part of a primary wound-treatment procedure.
Medicare pays $116.19–$130.69 for Q4351 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 Q4351 covers
Q4351 identifies Enclose TL Matrix as a product-specific wound matrix. The treating clinician places the product on a prepared wound as part of wound management; this code represents the product rather than the wound-preparation or application procedure. Wound-care physicians, podiatrists, and surgeons may use the matrix in office or hospital outpatient care when it is selected for a patient's wound.
Report Q4351 for the square centimeters of Enclose TL Matrix used, supported by documentation identifying the product, wound site, and area treated. Pair it with the required primary procedure; CMS treats Q4351 as an add-on, and payment falls within that procedure's global period. CMS classifies the code as technical-component-only, with interpretation covered by a separate code. Do not substitute another matrix product's HCPCS code when a different product was applied.
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 Q4351 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$116.19 to $130.69
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $127.89 | Unavailable |
| East St. Louis | $117.08 | Unavailable |
| Rest Of Illinois | $116.19 | Unavailable |
| Suburban Chicago | $130.69 | Unavailable |
How the Q4351 rate is calculated
Each of Q4351’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 · Q4351
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense3.81
3.81 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
3.8100
Conversion factor
$33.4009
Medicare rate
$127.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4351
The CMS indicators that decide how Q4351 is paid alongside other services.
CMS payment indicators · Q4351
Wound matrix
| 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. |
Q4351 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4350Wound matrix
- Q4350 identifies Palisade DM Matrix, while Q4351 identifies Enclose TL Matrix. Choose based on the documented product, not the wound's size.
- Q4352Wound matrix
- Q4352 identifies Overlay SL Matrix. Q4351 is specific to Enclose TL Matrix; the product used determines the code.
- Q4353Wound matrix
- Q4353 identifies Xceed TL Matrix. Use Q4351 only when Enclose TL Matrix is the product documented as applied.
Q4351 billing questions
When should Q4351 be selected instead of another matrix code?
Use Q4351 when the documented product is Enclose TL Matrix. A different matrix product has its own product-specific code.
Can Q4351 be billed by itself?
No. CMS identifies Q4351 as an add-on code that must be billed with a primary procedure, and its payment falls within that procedure's global period.
How is the quantity reported?
The code is reported per square centimeter. Documentation should support the area of Enclose TL Matrix used.
What should the record show?
Document the Enclose TL product, the wound site, the area treated, and the associated primary procedure.
Does Q4351 include interpretation?
CMS classifies Q4351 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 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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