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CMS RVU26D · Effective 2026-10-01

Q4238 Derm-Maxx Medicare reimbursement rates in Nebraska

Reports Derm-Maxx wound product by square centimeter when supplied with a primary wound procedure for application to a wound. Compare Q4238 office and facility rates across CMS payment localities in Nebraska.

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 Q4238 in Nebraska?

Nebraska 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

$117.46

1 of 1 localities have a supported rate.

Payment area: Nebraska

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.

Find Q4238 in your payment locality →

Wound care product

About Q4238: Derm-Maxx wound product by area

Reports Derm-Maxx wound product by square centimeter when supplied with a primary wound procedure for application to a wound.

Q4238 identifies Derm-Maxx supplied for wound coverage and is measured in square-centimeter units. It represents the product, not the clinician’s work applying it. Wound-care clinicians and surgeons may use the product during treatment of a wound; the application procedure is reported separately. The product code is distinct from codes for other wound products, even when they are also measured by area.

Report Q4238 only with a primary procedure, using documentation that identifies Derm-Maxx and supports the quantity supplied or applied in square centimeters. CMS treats it as an add-on paid within the primary procedure’s global period, so it is not a stand-alone service. CMS classifies the code as technical-component-only; a separate code covers interpretation. The record should distinguish product quantity from the wound’s dimensions and identify the accompanying procedure.

CMS billing rules for Q4238

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.

Q4238 compared with similar codes

Office rates for Nebraska, from the same CMS release.

15271

Skin substitute graft

First 25 cm², trunk/limbs

$145.75

15271 reports the wound application procedure for its specified body regions and initial treatment area. Q4238 reports the Derm-Maxx product by square centimeter and is billed with a primary procedure.

15275

Skin substitute

Face and other specified sites

$148.92

15275 is the application procedure for the head, neck, hands, feet, or genitalia. Q4238 identifies the product used, not the application.

Q4239

Amniotic graft

Amnio-Maxx or Lite, per square centimeter

$117.46

Q4239 identifies Amnio-Maxx or Lite, while Q4238 identifies Derm-Maxx. Use the code corresponding to the product documented.

Compare Q4238 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

Office and facility base rates · shared scale starting at $0

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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 Q4238 in Nebraska.

PPRRVU2026_Oct_nonQPP.csv

18,327

Code
Q4238
Physician work
0.00
Practice expense
3.81
Malpractice
0.00

GPCI2026.csv

72

Locality
Nebraska
Physician work
1.000
Practice expense
0.923
Malpractice
0.378
Office / nonfacility calculation for Q4238 in Nebraska
ComponentRVULocality factorAdjusted
Physician work0.00× 1.0000.0000
Practice expense3.81× 0.9233.5166
Malpractice0.00× 0.3780.0000
Total RVUs3.5166
Conversion factor× 33.4009

Office / nonfacility rate, Nebraska$117.46

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work01
Practice expense3.810.923
Malpractice00.378

(0 × 1 + 3.81 × 0.923 + 0 × 0.378) × $33.4009 = $117.46

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.

Q4238 billing questions

Does Q4238 report the product or its application?

It reports the Derm-Maxx product by square centimeter. Report the wound application procedure separately as the primary procedure.

Can Q4238 be billed by itself?

No. CMS identifies it as an add-on code that must be billed with a primary procedure and paid within that procedure’s global period.

How should the units be supported?

Document the product as Derm-Maxx and the quantity in square centimeters. The record should distinguish the amount supplied or applied from the wound’s measured dimensions.

Is an interpretation included in Q4238?

No. CMS classifies Q4238 as technical-component-only, with interpretation covered by a separate code.

How is Q4238 different from Q4239?

Q4238 identifies Derm-Maxx; Q4239 identifies Amnio-Maxx or Lite. Select the code matching the product documented, not merely the fact that both are reported by area.

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.

RVUs for Q4238PPRRVU2026_Oct_nonQPP.csv, line 18,327 (RVU26D)
Geographic factors for NebraskaGPCI2026.csv, line 72 (RVU26D)