$145.49
15271 reports the primary skin-substitute application work; Q4392 identifies the Grafix Duo product by square centimeter and is reported with a primary procedure.
On this page
CMS RVU26D · Effective 2026-10-01
Q4392 Skin substitute Medicare reimbursement rates in Oklahoma
Reports Grafix Duo by square centimeter when the product is used as a wound covering with a qualifying skin-substitute application procedure. Compare Q4392 office and facility rates across CMS payment localities in Oklahoma.
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 Q4392 in Oklahoma?
Oklahoma 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
$113.64
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 care supplies
About Q4392: Grafix Duo wound product
Reports Grafix Duo by square centimeter when the product is used as a wound covering with a qualifying skin-substitute application procedure.
Q4392 identifies Grafix Duo, a wound-care skin substitute product measured by the square centimeter. It is used when clinicians apply the product to a wound as part of wound management. Wound-care physicians, podiatrists, and surgeons may use skin substitutes in outpatient wound clinics or other settings where wounds are treated; the code identifies the product, not the clinician’s application work.
Report units according to the documented square centimeters of Grafix Duo used, and identify the product and treated wound in the record. Pair Q4392 with the primary skin-substitute application procedure appropriate to the wound site and treatment extent. CMS classifies Q4392 as an add-on code: it is billed only with a primary procedure, and payment falls within that procedure’s global period. CMS also classifies it as technical-component-only; a separate code covers interpretation.
CMS billing rules for Q4392
- 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.
Q4392 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
$113.64
Q4391 identifies Amnioplast Double. Choose between the product codes based on the product actually used, not the wound’s appearance.
$113.64
Q4393 identifies Surgraft AC, while Q4392 identifies Grafix Duo. The product documentation determines which code applies.
Compare Q4392 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
Oklahoma →
Office / nonfacility
$113.64
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 Q4392 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
18,477
- Code
- Q4392
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.893 | 3.4023 |
| Malpractice | 0.00 | × 0.777 | 0.0000 |
| Total RVUs | 3.4023 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Oklahoma$113.64
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.893 |
| Malpractice | 0 | 0.777 |
(0 × 1 + 3.81 × 0.893 + 0 × 0.777) × $33.4009 = $113.64
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.
Q4392 billing questions
Should Q4392 be reported instead of the skin-substitute application procedure?
No. Q4392 identifies the Grafix Duo product by square centimeter; report the applicable primary procedure for the clinician’s application work.
Can Q4392 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
How should the units be determined?
Use the documented square centimeters of Grafix Duo used. The record should identify the product and the wound treated.
What does the global-period rule mean for billing?
Q4392 is paid within the primary procedure’s global period, so it must be reported with that procedure rather than as a stand-alone service.
Does Q4392 include interpretation?
No. CMS classifies Q4392 as technical-component-only and identifies a separate code for interpretation.
Can Q4392 be used for another skin substitute product?
No. Use Q4392 only when the product used is Grafix Duo; select a different product code when another product was applied.
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.
18,474Q4389,,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
18,475Q4390,,Ascendion 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
18,476Q4391,,Amnioplast double 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
18,477Q4392,,Grafix duo 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
18,478Q4393,,Surgraft ac 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
18,479Q4394,,Surgraft aca 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
18,480Q4395,,Acelagraft 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
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193