$119.62
Q4101 identifies Apligraf, not GammaGraft. Choose the code matching the product actually furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4111 Skin substitute Medicare reimbursement rates in Utah
Report GammaGraft by square centimeter as the skin coverage product used with a primary wound procedure for eligible wounds or burns. Compare Q4111 office and facility rates across CMS payment localities in Utah.
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 Q4111 in Utah?
Utah 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
$119.62
1 of 1 localities have a supported rate.
Payment area: Utah
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
About Q4111: GammaGraft wound coverage product
Report GammaGraft by square centimeter as the skin coverage product used with a primary wound procedure for eligible wounds or burns.
Q4111 identifies GammaGraft, a human skin allograft used to cover a wound surface. Wound-care clinicians, surgeons, and podiatrists may use it in treatment of chronic ulcers, burns, and other wounds requiring skin coverage. The product line represents the graft itself, not the work of preparing the wound or applying the material; those services are represented by the applicable primary procedure.
Select Q4111 only when the documented product is GammaGraft, and report its quantity in square centimeters. The record should identify the product and support the amount used and the treated wound area. CMS classifies Q4111 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. CMS also classifies it as technical-component-only, with interpretation covered by a separate code.
CMS billing rules for Q4111
- 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.
Q4111 compared with similar codes
Office rates for Utah, from the same CMS release.
$119.62
Q4102 identifies Oasis wound matrix. Q4111 is specific to GammaGraft; the products are not interchangeable for coding.
$151.14
Q4111 reports the GammaGraft product by square centimeter; 15271 reports the primary application procedure for a wound on the trunk, arms, or legs.
Compare Q4111 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
Utah →
Office / nonfacility
$119.62
Facility
Unavailable
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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 Q4111 in Utah.
PPRRVU2026_Oct_nonQPP.csv
18,209
- Code
- Q4111
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.940 | 3.5814 |
| Malpractice | 0.00 | × 0.898 | 0.0000 |
| Total RVUs | 3.5814 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$119.62
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.94 |
| Malpractice | 0 | 0.898 |
(0 × 1 + 3.81 × 0.94 + 0 × 0.898) × $33.4009 = $119.62
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.
Q4111 billing questions
Can Q4111 be billed by itself?
No. CMS identifies Q4111 as an add-on code, so it must be reported with a primary procedure. Its payment falls within that procedure’s global period.
How should the quantity be reported?
Q4111 is reported per square centimeter. Document the GammaGraft product and the quantity used, with the treated wound area supporting the amount.
Is Q4111 the code for applying the graft?
No. Q4111 identifies the GammaGraft product. Report the applicable primary wound procedure for the service of preparing and treating the wound.
Does Q4111 include interpretation?
No. CMS classifies Q4111 as technical-component-only and states that a separate code covers interpretation.
Can Q4111 be used for another skin substitute product?
No. Use Q4111 only for GammaGraft; select the product code that matches the specific substitute documented.
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.
18,206Q4107,,Graftjacket,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
18,207Q4108,,Integra matrix,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
18,208Q4110,,Primatrix,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
18,209Q4111,,Gammagraft,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
18,210Q4112,,Cymetra injectable,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,211Q4113,,Graftjacket xpress,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,212Q4114,,Integra flowable wound matri,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985