$125.98
Q4426 identifies DermBnd TL+ or TLX variants; Q4428 identifies SLN, SL+, or SLX. Select the code matching the product variant used.
On this page
CMS RVU26D · Effective 2026-10-01
Q4428 DermBnd skin substitute Medicare reimbursement rates in Vermont
Reports DermBnd SLN, SL+, or SLX skin substitute by square centimeter for wound coverage when paired with an applicable application procedure. Compare Q4428 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 Q4428 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.
Skin substitute product
About Q4428: DermBnd SLN wound product
Reports DermBnd SLN, SL+, or SLX skin substitute by square centimeter for wound coverage when paired with an applicable application procedure.
Q4428 identifies DermBnd SLN, SL+, or SLX material furnished for coverage of a wound, measured by treated area in square centimeters. Wound-care clinicians and surgeons use skin-substitute products as part of wound management in settings such as outpatient wound clinics and hospital outpatient departments. The application service describes placement on the wound; Q4428 represents the named product rather than the clinician’s application work.
Report units based on the square centimeters of product used, and document the DermBnd variant and treated wound area so the quantity can be traced to the record. Q4428 is an add-on: submit it with the applicable primary application procedure, and CMS pays it within that procedure’s global period. CMS classifies Q4428 as technical-component-only; a separate code covers interpretation. Its work RVU is zero, so the code represents product and technical expense rather than physician interpretation.
CMS billing rules for Q4428
- 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.
Q4428 compared with similar codes
Office rates for Vermont, from the same CMS release.
$125.98
Q4427 identifies DermBnd DLN, DL+, or DLX variants. Q4428 is for the SLN, SL+, or SLX variants.
$125.98
Q4429 identifies DermBnd CHN or CHX variants, rather than the SLN, SL+, or SLX variants represented by Q4428.
Compare Q4428 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 Q4428 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
18,513
- Code
- Q4428
- 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.
Q4428 billing questions
What should be documented for Q4428?
Record the DermBnd variant used, the treated wound area, and the product quantity in square centimeters. The documentation should support the units reported.
Can Q4428 be billed by itself?
No. It is an add-on code and must be reported with an applicable primary application procedure.
How are Q4428 units determined?
Report the product quantity by square centimeter. The documented product use and treated area should support the units.
How does Q4428 relate to interpretation?
CMS classifies Q4428 as technical-component-only. A separate code covers interpretation.
How do I distinguish Q4428 from other DermBnd codes?
Match the product variant to its code: Q4428 identifies SLN, SL+, or SLX. Q4426, Q4427, and Q4429 identify other DermBnd variants.
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.
18,510Q4425,,Revive tl 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
18,511Q4426,,"Dermbnd tl+, tlx 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
18,512Q4427,,Dermbnd dln dl+ dlx 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
18,513Q4428,,Dermbnd sln sl+ slx 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
18,514Q4429,,"Dermbnd chn, chx 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
18,515Q4431,,"Pma skin substitute, nos",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
18,516Q4432,,"510(k) skin subs, nos",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
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