Q4145
No office rateEpifix, inj, 1mg
Q4145 identifies an injectable EpiFix product and uses a milligram unit; Q4146 identifies TenSIX by square-centimeter unit.
On this page
CMS RVU26D · Effective 2026-10-01
Q4146 Wound matrix Medicare reimbursement rates in Kentucky
Report TenSIX by square-centimeter unit when the product is furnished for wound coverage with a qualifying skin-substitute application procedure. Compare Q4146 office and facility rates across CMS payment localities in Kentucky.
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 Q4146 in Kentucky?
Kentucky 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
$113.13
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 product
About Q4146: TenSIX wound matrix per square centimeter
Report TenSIX by square-centimeter unit when the product is furnished for wound coverage with a qualifying skin-substitute application procedure.
TenSIX is a biologic wound-covering product used in skin-substitute treatment of wounds, including chronic ulcers. A wound-care clinician, podiatrist, or surgeon may apply it after preparing the wound bed in an outpatient or surgical setting. The product code identifies the TenSIX material, not the work of preparing or applying the wound coverage.
Report one unit for each square centimeter of product furnished, alongside the primary skin-substitute application procedure appropriate to the treated site and area. The record should identify the product, wound location and dimensions, amount used, and application procedure. CMS treats Q4146 as an add-on: submit it only with a primary procedure, and its payment falls within that procedure's global period. It is technical-component-only; interpretation is represented separately.
CMS billing rules for Q4146
- 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.
Q4146 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$113.13
Q4147 identifies Architect ECM PX FX by square-centimeter unit. Use Q4146 only when TenSIX is the product furnished.
Compare Q4146 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
Kentucky →
Office / nonfacility
$113.13
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 Q4146 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
18,239
- Code
- Q4146
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.889 | 3.3871 |
| Malpractice | 0.00 | × 0.915 | 0.0000 |
| Total RVUs | 3.3871 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$113.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.889 |
| Malpractice | 0 | 0.915 |
(0 × 1 + 3.81 × 0.889 + 0 × 0.915) × $33.4009 = $113.13
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.
Q4146 billing questions
How is Q4146 different from Q4145?
Q4146 identifies TenSIX by square-centimeter unit. Q4145 identifies an injectable EpiFix product by milligram, so select the code for the product actually furnished.
What primary procedure should accompany Q4146?
Report it with the skin-substitute application procedure that fits the wound site and treated area, such as CPT 15271 or 15275 when applicable.
How many units should be reported?
Report one unit per square centimeter of TenSIX furnished. Document the wound dimensions and the amount of product used to support the units.
Is the application separately represented by Q4146?
No. Q4146 identifies the TenSIX product; report the appropriate primary procedure for the application. CMS treats Q4146 as an add-on paid within that procedure's global period.
Does Q4146 include interpretation?
No. CMS classifies Q4146 as technical-component-only, with interpretation covered by a separate code.
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.
18,236Q4142,,Xcm biologic tiss matrix 1cm,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
18,237Q4143,,"Repriza, 1cm",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
18,238Q4145,,"Epifix, inj, 1mg",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
18,239Q4146,,"Tensix, 1cm",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
18,240Q4147,,Architect ecm px fx 1 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
18,241Q4148,,Neox neox rt or clarix cord,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
18,242Q4149,,"Excellagen, 0.1 cc",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
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631