HCPCS code Q4255: Wound product2026 Medicare rate & RVUs in Oklahoma
Reguard is a topical wound-covering product reported by the square centimeter with a primary wound application procedure.
Medicare pays $113.64 for Q4255 in the office in Oklahoma (Oklahoma). 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 Q4255 covers
Q4255 identifies Reguard used topically as a wound-covering product. Wound care clinicians, surgeons, and podiatrists may apply it during treatment of wounds in an office wound clinic or hospital outpatient setting. The product code represents the material, not the clinical work of preparing and treating the wound or applying the product.
Report units according to the square-centimeter amount applied, and pair Q4255 with the primary procedure for the wound application. Documentation should identify Reguard, the treated wound, and the amount applied so the billed units can be supported. CMS classifies this as an add-on code: it is billed only with a primary procedure, and its payment falls within that procedure’s global period. CMS assigns practice-expense value rather than work value. It is technical-component-only; a separate code covers interpretation.
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.
Q4255 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $113.64 | Unavailable |
How the Q4255 rate is calculated
Each of Q4255’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 · Q4255
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 Q4255
The CMS indicators that decide how Q4255 is paid alongside other services.
CMS payment indicators · Q4255
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. |
Q4255 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- Q4254Wound matrix
- Q4254 identifies Novafix DL, not Reguard. Select the product code that matches the material actually applied.
- Q4256MLG Complete
- Q4256 identifies MLG Complete. It is not interchangeable with Q4255 when Reguard was the product used.
- 15271Skin substitute graft
- 15271 reports the wound application procedure for its specified body sites; Q4255 reports the Reguard product used with a primary procedure.
- 15275Skin substitute
- 15275 is the application-procedure code for its specified anatomic sites. Q4255 identifies the product, not the site-based application service.
Q4255 billing questions
Can Q4255 be billed by itself?
No. CMS identifies Q4255 as an add-on code that must be billed with a primary procedure.
How should the number of units be determined?
Use the square-centimeter amount of Reguard applied. Document the treated area and amount used to support the units.
Does Q4255 include the wound application procedure?
No. Q4255 identifies the Reguard product; report it with the applicable primary wound application procedure.
Is interpretation included in Q4255?
No. CMS classifies Q4255 as technical-component-only and states that a separate code covers interpretation.
How does the global-period rule affect payment?
Q4255 is paid within the global period of the primary procedure with which it is billed.
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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