$113.13
Q4154 identifies Biovance, while Q4165 identifies Keramatrix or Kerasorb. Choose the code for the product actually furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4165 Wound matrix Medicare reimbursement rates in Kentucky
Report Q4165 for each square centimeter of Keramatrix or Kerasorb wound matrix furnished with a primary procedure for wound treatment. Compare Q4165 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 Q4165 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
About Q4165: Keramatrix or Kerasorb wound matrix
Report Q4165 for each square centimeter of Keramatrix or Kerasorb wound matrix furnished with a primary procedure for wound treatment.
Q4165 identifies Keramatrix or Kerasorb wound matrix supplied for placement on a wound. A wound-care clinician, surgeon, or podiatrist may use the product as part of treating a wound that requires a matrix dressing. The code represents the named product, not the clinician’s wound assessment or the primary procedure used to prepare or treat the wound. The claim unit is based on square centimeters, so the product name and quantity used should be clear in the record.
CMS classifies Q4165 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. CMS also identifies it as technical-component-only, with interpretation covered by a separate code when applicable. Its physician fee schedule valuation assigns practice-expense value but no work or malpractice RVUs. Documentation should identify Keramatrix or Kerasorb, the wound treated, the amount furnished, and the associated primary procedure.
CMS billing rules for Q4165
- 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.
Q4165 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$113.13
Q4158 identifies Kerecis Omega3; Q4165 is for Keramatrix or Kerasorb. The product name, not a general wound-matrix resemblance, determines the code.
$113.13
Q4166 identifies Cytal, whereas Q4165 identifies Keramatrix or Kerasorb. Report the specific product used and its corresponding code.
Compare Q4165 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 Q4165 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
18,258
- Code
- Q4165
- 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.
Q4165 billing questions
Can Q4165 be billed by itself?
No. CMS classifies it as an add-on code, so it must be billed with a primary procedure.
How are Q4165 units counted?
The code is measured per square centimeter. Document the Keramatrix or Kerasorb product and the quantity furnished in square centimeters.
Can Q4165 be reported with a wound procedure on the same claim?
Yes, when the product is furnished with a primary procedure. CMS places payment for Q4165 within that procedure’s global period.
Does Q4165 include interpretation?
No. CMS designates Q4165 as technical-component-only and indicates that a separate code covers interpretation when applicable.
What documentation supports Q4165?
Record the specific product used, the wound treated, the square centimeters furnished, and the primary procedure reported with the add-on.
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.
18,255Q4162,,"Wndex flw, bioskn flw, 0.5cc",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
18,256Q4163,,"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
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