HCPCS Q4178: Wound productMedicare rate & RVUs in Nevada
Reports the per-square-centimeter amount of FlowerAmnioPatch used with a primary wound procedure, such as application of a skin substitute graft.
Medicare pays $127.38 for Q4178 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What Q4178 covers
FlowerAmnioPatch is an amniotic tissue product applied to a wound as part of wound management. Clinicians may use this type of product for chronic or hard-to-heal wounds, including lower-extremity ulcers. Wound-care physicians, surgeons, and other qualified practitioners typically apply it in an office or outpatient setting. Q4178 identifies the product quantity, not the wound assessment or the application service itself.
Report the number of square centimeters represented by the product used, supported by documentation of the product and treated wound area. Submit Q4178 with the primary procedure; CMS treats it as an add-on and pays it within that procedure’s global period. CMS classifies the code as technical-component-only, with interpretation covered by a separate code. The product code is distinct from the application code, so documentation should identify both the graft application service and the FlowerAmnioPatch quantity.
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.
Q4178 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $127.38 | Unavailable |
How the Q4178 rate is calculated
Each of Q4178’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · Q4178
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense3.81
3.81 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
3.8100
Conversion factor
$33.4009
Medicare rate
$127.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4178
The CMS indicators that decide how Q4178 is paid alongside other services.
CMS payment indicators · Q4178
Wound product
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4178 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4177Floweramnioflo, 0.1 cc
- Q4177 identifies FlowerAmnioFlo and uses 0.1 cc units; Q4178 identifies FlowerAmnioPatch and uses square-centimeter units.
- Q4179Wound product
- Q4179 identifies FlowerDerm, not FlowerAmnioPatch. Match the HCPCS code to the product documented and the applicable unit.
- Q4186EpiFix material
- Q4186 identifies EpiFix, a different amniotic tissue product. Use Q4178 only when the product applied is FlowerAmnioPatch.
Q4178 billing questions
How is Q4178 different from Q4177?
Q4178 identifies FlowerAmnioPatch by square centimeter. Q4177 identifies FlowerAmnioFlo in 0.1 cc units, so select the code matching the product and its stated unit.
Can Q4178 be billed by itself?
No. CMS designates it as an add-on code, so it is reported with a primary procedure and paid within that procedure’s global period.
Is the wound application included in Q4178?
Q4178 identifies the FlowerAmnioPatch product quantity. Report the applicable primary wound procedure for the application service.
What quantity should the claim show?
Use the number of square centimeters represented by the product used. The record should support the product identity and treated wound area.
Does Q4178 include interpretation?
CMS classifies Q4178 as technical-component-only; a separate code covers interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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