$117.46
Q4353 identifies Xceed TL Matrix. Q4354 is specific to Palingen DL or Palingen DL-X; select by the product documented as furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4354 Wound matrix Medicare reimbursement rates in Nebraska
Q4354 identifies Palingen DL or Palingen DL-X furnished for wound treatment and reported as an add-on with a primary procedure. Compare Q4354 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 Q4354 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.
Wound biologic
About Q4354: Palingen DL wound product
Q4354 identifies Palingen DL or Palingen DL-X furnished for wound treatment and reported as an add-on with a primary procedure.
Q4354 identifies the Palingen DL and Palingen DL-X wound products. They are used by clinicians treating difficult-to-heal wounds, including diabetic foot or venous leg ulcers, as part of a wound-care procedure. Wound care clinicians, podiatrists, and surgeons may furnish the product in an office, wound clinic, or hospital setting. Select this code only when the product used is Palingen DL or Palingen DL-X; a different wound matrix has its own product code.
Report Q4354 only with a primary procedure. CMS treats it as an add-on paid within that procedure’s global period, so it is not a standalone service. Keep documentation identifying the product, the treated wound, the amount used, and the associated primary procedure. CMS classifies Q4354 as technical-component-only; a separate code covers interpretation. Its CMS relative-value profile includes practice expense, with zero work and malpractice RVUs.
CMS billing rules for Q4354
- 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.
Q4354 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$117.46
Q4352 identifies Overlay SL Matrix, while Q4354 identifies Palingen DL or Palingen DL-X. These product-specific codes are not interchangeable.
$117.46
Q4355 identifies Abio XPL. Use Q4354 only when Palingen DL or Palingen DL-X was furnished.
Compare Q4354 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
Nebraska →
Office / nonfacility
$117.46
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 Q4354 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
18,441
- Code
- Q4354
- 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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.923 | 3.5166 |
| Malpractice | 0.00 | × 0.378 | 0.0000 |
| Total RVUs | 3.5166 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$117.46
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.923 |
| Malpractice | 0 | 0.378 |
(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.
Q4354 billing questions
Can Q4354 be billed by itself?
No. CMS identifies Q4354 as an add-on that must be billed with a primary procedure and is paid within that procedure’s global period.
What documentation supports Q4354?
Document that Palingen DL or Palingen DL-X was furnished, identify the treated wound and amount used, and link the product to the primary procedure.
Does Q4354 include interpretation?
No. CMS classifies Q4354 as technical-component-only and indicates that a separate code covers interpretation.
How should the product be distinguished from another wound matrix?
Use Q4354 only for Palingen DL or Palingen DL-X. Select the product-specific code when a different matrix is furnished.
What does the CMS relative-value profile show?
It assigns practice-expense value and zero work and malpractice RVUs. The code is classified as technical-component-only.
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.
18,438Q4351,,"Enclose tl matrix, 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
18,439Q4352,,"Overlay sl matrix, 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
18,440Q4353,,Xceed tl matrix 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
18,441Q4354,,Palingen dl-palingen dl-x,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
18,442Q4355,,Abio xpl abio xpl hy p 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
18,443Q4356,,Abio mem abio hyd 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
18,444Q4357,,"Xwrap plus, 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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068