$153.50
15271 reports the application procedure for qualifying wounds of the trunk, arms, or legs; Q4276 reports the Orion product by area.
On this page
CMS RVU26D · Effective 2026-10-01
Q4276 Skin substitute Medicare reimbursement rates in Vermont
Report Q4276 for each square centimeter of Orion used with a primary wound procedure when a skin substitute is applied to a wound. Compare Q4276 office and facility rates across CMS payment localities in Vermont.
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 Q4276 in Vermont?
Vermont 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
$125.98
1 of 1 localities have a supported rate.
Payment area: Vermont
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 product
About Q4276: Orion skin substitute, per square centimeter
Report Q4276 for each square centimeter of Orion used with a primary wound procedure when a skin substitute is applied to a wound.
Q4276 identifies Orion, a wound-care skin substitute, by the area used. It represents the product rather than the clinician’s work to prepare the wound or apply the material. Wound-care clinicians, surgeons, podiatrists, and other qualified practitioners may use a skin substitute when treating wounds such as diabetic foot ulcers or venous leg ulcers. The application procedure is reported separately according to the wound site and treated area.
Report Q4276 only with a primary procedure, and base the quantity on the square centimeters of Orion used. Documentation should identify the product and support the amount applied, along with the wound and the related application procedure. CMS treats Q4276 as an add-on code paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation.
CMS billing rules for Q4276
- 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.
Q4276 compared with similar codes
Office rates for Vermont, from the same CMS release.
$309.88
15273 reports the application procedure for qualifying wounds at its specified other sites; Q4276 reports the Orion product, not the application.
$24.76
15272 reports additional application area with its primary procedure. Q4276 counts Orion product area and is not an application-area code.
Compare Q4276 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
Vermont →
Office / nonfacility
$125.98
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 Q4276 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
18,364
- Code
- Q4276
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.990 | 3.7719 |
| Malpractice | 0.00 | × 0.506 | 0.0000 |
| Total RVUs | 3.7719 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$125.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.99 |
| Malpractice | 0 | 0.506 |
(0 × 1 + 3.81 × 0.99 + 0 × 0.506) × $33.4009 = $125.98
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.
Q4276 billing questions
Does Q4276 report the wound application procedure?
No. Q4276 identifies the Orion product by area; report the appropriate primary wound application procedure separately.
Can Q4276 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
How should the quantity be determined?
Report the square centimeters of Orion used. Documentation should support the product and area applied.
Does Q4276 include interpretation?
No. CMS classifies Q4276 as technical-component-only, with a separate code covering interpretation.
Which primary procedure should accompany Q4276?
Select the wound application procedure based on the wound site and treated area; Q4276 identifies the product, not the application method.
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.
18,361Q4273,,"Esano aaa, 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
18,362Q4274,,"Esano 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
18,363Q4275,,"Esano 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
18,364Q4276,,"Orion, 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
18,365Q4278,,"Epieffect, 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
18,366Q4279,,"Vendaje 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
18,367Q4280,,Xcell amnio matrix 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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817