HCPCS code Q4146: Wound matrix2026 Medicare rate & RVUs in Oregon
Report TenSIX by square-centimeter unit when the product is furnished for wound coverage with a qualifying skin-substitute application procedure.
Medicare pays $126.75–$141.38 for Q4146 in the office in Oregon, from Rest Of Oregon to Portland. 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 Q4146 covers
TenSIX is a biologic wound-covering product used in skin-substitute treatment of wounds, including chronic ulcers. A wound-care clinician, podiatrist, or surgeon may apply it after preparing the wound bed in an outpatient or surgical setting. The product code identifies the TenSIX material, not the work of preparing or applying the wound coverage.
Report one unit for each square centimeter of product furnished, alongside the primary skin-substitute application procedure appropriate to the treated site and area. The record should identify the product, wound location and dimensions, amount used, and application procedure. CMS treats Q4146 as an add-on: submit it only with a primary procedure, and its payment falls within that procedure's global period. It is technical-component-only; interpretation is represented separately.
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.
Where Q4146 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $141.38 | Unavailable |
| Rest Of Oregon | $126.75 | Unavailable |
How the Q4146 rate is calculated
Each of Q4146’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 · Q4146
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 Q4146
The CMS indicators that decide how Q4146 is paid alongside other services.
CMS payment indicators · Q4146
Wound matrix
| 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. |
Q4146 compared with similar codes
Compare codes · National
Q4146 vs Q4145 vs Q4147: Medicare rates
How to choose
Q4146 billing questions
How is Q4146 different from Q4145?
Q4146 identifies TenSIX by square-centimeter unit. Q4145 identifies an injectable EpiFix product by milligram, so select the code for the product actually furnished.
What primary procedure should accompany Q4146?
Report it with the skin-substitute application procedure that fits the wound site and treated area, such as CPT 15271 or 15275 when applicable.
How many units should be reported?
Report one unit per square centimeter of TenSIX furnished. Document the wound dimensions and the amount of product used to support the units.
Is the application separately represented by Q4146?
No. Q4146 identifies the TenSIX product; report the appropriate primary procedure for the application. CMS treats Q4146 as an add-on paid within that procedure's global period.
Does Q4146 include interpretation?
No. CMS classifies Q4146 as technical-component-only, with interpretation covered by a separate code.
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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