$117.46
Q4385 identifies Apollo FT. Use Q4386 for Acesso Tri-Fa; the product actually furnished determines the supply code.
On this page
CMS RVU26D · Effective 2026-10-01
Q4386 Wound graft Medicare reimbursement rates in Nebraska
Reports Acesso Tri-Fa wound graft material by square centimeter when furnished with a primary wound-application procedure. Compare Q4386 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 Q4386 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.
Skin substitute
About Q4386: Acesso Tri-Fa wound graft supply
Reports Acesso Tri-Fa wound graft material by square centimeter when furnished with a primary wound-application procedure.
Q4386 identifies Acesso Tri-Fa wound graft material, with the quantity reported in square centimeters. It represents the product supplied, not a standalone wound-care service. In outpatient wound care, a treating clinician may place the material on a prepared wound bed during a separately coded graft-application procedure. Select this code when Acesso Tri-Fa is the product furnished; the code is not selected by wound severity or size alone.
CMS classifies Q4386 as an add-on, so report it only with an applicable primary procedure; its payment falls within that procedure’s global period. CMS also classifies it as technical-component-only, with a separate code covering interpretation. Documentation should identify the product, wound site, quantity in square centimeters, and associated primary procedure. The product-specific documentation supports distinguishing Q4386 from codes for other wound materials.
CMS billing rules for Q4386
- 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.
Q4386 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$117.46
Q4387 identifies Neothelium FT. It is not interchangeable on the claim with Q4386 when Acesso Tri-Fa was furnished.
$117.46
Q4388 identifies a different Neothelium product. Q4386 is specific to Acesso Tri-Fa.
Compare Q4386 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 Q4386 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
18,471
- Code
- Q4386
- 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.
Q4386 billing questions
When should Q4386 be reported instead of another wound-product code?
Report Q4386 when the material furnished is Acesso Tri-Fa. Codes for other named products, such as Apollo FT or Neothelium FT, identify different supplies.
Can Q4386 be billed by itself?
No. CMS identifies it as an add-on that must be reported with a primary procedure. Payment is within that procedure’s global period.
How should the quantity be reported?
Report the amount of Acesso Tri-Fa in square centimeters. The record should support the product and quantity furnished.
Does Q4386 include interpretation?
No. CMS classifies Q4386 as technical-component-only and indicates that a separate code covers interpretation.
What documentation supports reporting Q4386?
Document Acesso Tri-Fa as the product used, the wound site, the square-centimeter quantity, and the associated primary application procedure.
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.
18,468Q4383,,Axolotl graft ult 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
18,469Q4384,,Axolotl dual ult 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
18,470Q4385,,Apollo ft 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
18,471Q4386,,Acesso trifaca 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
18,472Q4387,,Neothelium ft 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
18,473Q4388,,Neothelium 4l 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
18,474Q4389,,Neothelium 4l+ 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