$134.00–$156.14
Use Q4186 for EpiFix and Q4187 for Epicord. Both are product-specific codes with a square-centimeter unit, but they identify different materials.
On this page
CMS RVU26D · Effective 2026-10-01
Q4186 EpiFix material Medicare reimbursement rates in Washington
Q4186 reports EpiFix amniotic membrane material by square centimeter when it is furnished with a primary wound procedure. Compare Q4186 office and facility rates across CMS payment localities in Washington.
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 Q4186 in Washington?
Washington 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
$134.00–$156.14
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.
Skin substitute products
About Q4186: EpiFix amniotic membrane by area
Q4186 reports EpiFix amniotic membrane material by square centimeter when it is furnished with a primary wound procedure.
Q4186 identifies EpiFix, an amniotic membrane product used as a wound covering. Wound-care clinicians, podiatrists, and surgeons may apply it to chronic wounds such as diabetic foot ulcers or venous leg ulcers in office or hospital outpatient settings. The product code represents the material, not the clinician’s wound assessment or the application service.
Report one unit for each square centimeter represented by the product amount, supported by the product record and wound documentation. CMS classifies Q4186 as an add-on code: bill it only with a primary procedure, and its payment falls within that procedure’s global period. CMS also identifies it as technical-component-only, with a separate code covering interpretation. Pair it with the applicable wound procedure for the treated site and area; the record should identify the product, wound location, treated area, and amount used.
CMS billing rules for Q4186
- 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.
Q4186 compared with similar codes
Office rates for Washington, from the same CMS release.
$134.00–$156.14
Q4188 identifies AmnioArmor, not EpiFix. Choose according to the product furnished, not simply because both are reported by area.
$162.36–$182.34
Q4186 reports the EpiFix material; 15271 reports an application procedure for qualifying trunk, arm, or leg wounds. They serve different parts of the encounter.
Compare Q4186 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
Rest Of Washington →
Office / nonfacility
$134.00
Facility
Unavailable
Seattle (King Cnty) →
Office / nonfacility
$156.14
Facility
Unavailable
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Q4186 billing questions
How is Q4186 different from Q4187?
Q4186 identifies EpiFix; Q4187 identifies Epicord. Select the code matching the product furnished, rather than choosing between them by wound site or area.
How many units should be reported?
Each Q4186 unit represents one square centimeter. Documentation should support the product amount reported and the wound area treated.
Can Q4186 be billed by itself?
No. CMS identifies Q4186 as an add-on code billed only with a primary procedure.
Is the wound application included in Q4186?
Q4186 identifies the EpiFix material. Report the applicable primary wound procedure for the application service when the procedure is performed.
What does technical-component-only mean for this code?
CMS classifies Q4186 as technical-component-only and indicates that a separate code covers interpretation.
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.
18,275Q4183,,"Surgigraft, 1 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
18,276Q4184,,Cellesta or duo 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
18,277Q4185,,Cellesta flowab amnion 0.5cc,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
18,278Q4186,,Epifix 1 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
18,279Q4187,,Epicord 1 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
18,280Q4188,,Amnioarmor 1 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
18,281Q4189,,"Artacent ac, 1 mg",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