HCPCS Q4395: AcelagraftMedicare rate & RVUs in Oregon
Q4395 reports Acelagraft by square centimeter as a wound-care product used with a primary procedure that applies the material.
Medicare pays $126.75–$141.38 for Q4395 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 Q4395 covers
Q4395 identifies Acelagraft by square centimeter for wound-care use. It represents the product, not the clinical work of preparing the wound or applying the graft. Wound-care clinicians, surgeons, and other qualified practitioners may use the material while treating a wound in an office, wound clinic, or hospital setting. The product and quantity reported should match what was actually used; the code alone does not identify the wound type or treatment method.
Report Q4395 with the primary procedure that applies the product. CMS treats it as an add-on and pays it within that procedure’s global period, so it is not a stand-alone service. Document the product identity, wound site and dimensions, amount used, and related application procedure to support the reported units. CMS classifies Q4395 as technical-component-only; interpretation is represented by a separate code.
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 Q4395 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $141.38 | Unavailable |
| Rest Of Oregon | $126.75 | Unavailable |
How the Q4395 rate is calculated
Each of Q4395’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 · Q4395
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 Q4395
The CMS indicators that decide how Q4395 is paid alongside other services.
CMS payment indicators · Q4395
Acelagraft
| 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. |
Q4395 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 15271Skin substitute graft
- Q4395 identifies the Acelagraft product; 15271 reports application for qualifying wounds on the trunk, arms, or legs. The codes represent different parts of the service.
- 15273Skin substitute graft
- Q4395 identifies the product. Use 15273 for application to qualifying wounds on the face, scalp, neck, hands, feet, or genitalia.
- Q4394Wound graft
- Q4394 identifies Surgraft ACA, while Q4395 identifies Acelagraft. Select the product code that matches the material used.
- Q4396Natalin graft
- Q4396 identifies Natalin, not Acelagraft. The product documented as used determines which code applies.
Q4395 billing questions
Can Q4395 be reported by itself?
No. CMS identifies it as an add-on code, so report it with the primary procedure that applies the product.
How should the quantity be supported?
The descriptor is per square centimeter. Document the product used and the amount applied, along with the wound site and dimensions.
Does Q4395 include wound preparation or application?
No. Q4395 identifies the Acelagraft product; the primary procedure represents the application service.
Is interpretation included in Q4395?
No. CMS classifies Q4395 as technical-component-only and identifies interpretation as covered by a separate code.
When is Q4395 paid in relation to the primary procedure?
CMS places payment for Q4395 within the primary procedure’s global period. Report it with the related primary procedure rather than as a separate stand-alone service.
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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