$125.09–$149.91
Q4266 identifies Neostim without the TL designation. Match the claim to the specific product used.
On this page
CMS RVU26D · Effective 2026-10-01
Q4265 Skin substitute Medicare reimbursement rates in Virginia
Report Neostim TL by square centimeter when this specific wound product is furnished with a qualifying primary application procedure. Compare Q4265 office and facility rates across CMS payment localities in Virginia.
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 Q4265 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$125.09–$149.91
2 of 2 localities have a supported rate.
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 Q4265: Neostim TL wound product
Report Neostim TL by square centimeter when this specific wound product is furnished with a qualifying primary application procedure.
Q4265 identifies the Neostim TL wound product by the square centimeter. It represents the product used during wound treatment, rather than the clinician’s wound assessment or the application procedure itself. Wound care specialists, surgeons, and other clinicians may use skin substitute products in outpatient wound clinics, physician offices, or hospital outpatient departments for wounds requiring advanced wound management.
Report Q4265 only with a primary procedure, using the product actually furnished and the applicable quantity in square centimeters. Documentation should identify Neostim TL, the wound treated, the area for which product was used, and the associated application procedure. CMS treats Q4265 as an add-on code paid within the primary procedure’s global period. CMS also classifies it as technical-component-only; the interpretation is covered by a separate code. The product code does not replace the application code, which is selected based on the wound site and applicable area criteria.
CMS billing rules for Q4265
- 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.
Q4265 compared with similar codes
Office rates for Virginia, from the same CMS release.
$125.09–$149.91
Q4267 identifies Neostim DL, a distinct product form. Do not substitute it for Neostim TL based only on wound site or size.
$154.19–$179.60
Q4265 reports the Neostim TL product by area; 15271 reports application to qualifying trunk, arm, or leg wounds.
$156.76–$181.06
Q4265 identifies the product, while 15275 reports application at its specified anatomic sites. Select the application code by site and area criteria.
Compare Q4265 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
$149.91
Facility
Unavailable
Virginia →
Office / nonfacility
$125.09
Facility
Unavailable
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Q4265 billing questions
How is Q4265 distinguished from other Neostim codes?
Use Q4265 only when the product furnished is Neostim TL. Neostim and Neostim DL have separate HCPCS codes, so verify the product identity rather than choosing by wound characteristics.
What primary service must accompany Q4265?
CMS identifies Q4265 as an add-on code, so it is billed with a primary procedure. For skin substitute application, the applicable procedure code depends on the wound site and area.
What documentation supports the units?
Document the Neostim TL product, the wound site, the area treated, and the quantity used in square centimeters, along with the associated primary procedure.
Is the application procedure included in Q4265?
No. Q4265 identifies the product; the wound application is represented by its own primary procedure code.
How does CMS treat the code’s component and global status?
CMS classifies Q4265 as technical-component-only, with interpretation covered separately. It is paid within the global period of the primary procedure.
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.
18,350Q4262,,"Dual layer impax, 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
18,351Q4263,,"Surgraft 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
18,352Q4264,,"Cocoon membrane, 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
18,353Q4265,,Neostim 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
18,354Q4266,,Neostim 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
18,355Q4267,,Neostim dl 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
18,356Q4268,,Surgraft ft 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