HCPCS Q4218: Wound graftMedicare rate & RVUs in Oregon
Report Q4218 for the documented square-centimeter quantity of Surgicord tissue supplied with a primary wound or surgical procedure.
Medicare pays $126.75–$141.38 for Q4218 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 Q4218 covers
Surgicord is a human umbilical cord tissue product reported by treated surface area when supplied and placed during wound or surgical treatment. A surgeon or other qualified clinician may use it as a biologic covering in wound-care or operative settings; the procedure itself is reported separately with the applicable primary service. The record should identify Surgicord rather than another graft product and show the area treated.
Report Q4218 only with a primary procedure; CMS classifies it as an add-on and places its payment within that procedure’s global period. The per-square-centimeter unit should be supported by documentation of the product quantity used. Keep the product label, operative or wound-care note, site, treated area, and amount applied to substantiate the units and distinguish Surgicord from similarly measured graft products. CMS classifies Q4218 as technical-component-only; a separate code covers interpretation, so Q4218 is not the professional interpretation service.
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 Q4218 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $141.38 | Unavailable |
| Rest Of Oregon | $126.75 | Unavailable |
How the Q4218 rate is calculated
Each of Q4218’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 · Q4218
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 Q4218
The CMS indicators that decide how Q4218 is paid alongside other services.
CMS payment indicators · Q4218
Wound graft
| 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. |
Q4218 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4219Wound graft product
- Q4219 identifies Surgigraft dual, while Q4218 identifies Surgicord. Match the code to the tissue product documented as supplied.
- Q4214Wound graft
- Q4214 is for Cellesta cord. Both are measured by area, so the product name—not the unit of measure—distinguishes the codes.
- Q4216Wound product
- Q4216 identifies Artacent cord rather than Surgicord. Report the code for the specific product used.
Q4218 billing questions
Can Q4218 be billed by itself?
No. CMS identifies Q4218 as an add-on code that must be reported with a primary procedure, and its payment falls within that procedure’s global period.
How are units determined?
The code is measured per square centimeter. Document the Surgicord quantity used so the reported units are supported.
What documentation supports Q4218?
The record should identify Surgicord, the treatment site, the primary procedure, the area treated, and the quantity applied.
Does Q4218 include professional interpretation?
No. CMS classifies Q4218 as technical-component-only, with a separate code covering interpretation.
How do I choose between Q4218 and another graft code?
Use Q4218 when the product supplied is Surgicord. Codes for other tissue products represent those products, even when they are also measured by area.
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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