Q4100 HCPCS code: Skin substitute, not otherwise specified
Q4100 is the HCPCS Level II code for skin substitute, not otherwise specified. In 2022 Medicare paid an average of $466.97 per service for Q4100 across 88 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2022, about 6 clinicians billed Medicare for Q4100 for 11 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2009-01-01 |
| Last action effective | 2009-01-01 |
Who bills Q4100 (2022)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 6 |
| Medicare beneficiaries | 11 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4100, 2022–2022
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 88 | 11 | $585.13 | $466.97 |
What changed for Q4100
- 2009-01-01: Q4100 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q4100?
Q4100 is the HCPCS Level II code for skin substitute, not otherwise specified. Short descriptor: "Skin substitute, nos".
How much does Medicare pay for Q4100?
In 2022, the average Medicare payment was $466.97 per service (average allowed $585.13).
Does Medicare cover Q4100?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q41 codes
- Q4101 — Apligraf, per square centimeter
- Q4102 — Oasis wound matrix, per square centimeter
- Q4103 — Oasis burn matrix, per square centimeter
- Q4104 — Integra bilayer matrix wound dressing (bmwd), per square centimeter
- Q4105 — Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter
- Q4106 — Dermagraft, per square centimeter
- Q4107 — Graftjacket, per square centimeter
- Q4108 — Integra matrix, per square centimeter
- Q4110 — Primatrix, per square centimeter
- Q4111 — Gammagraft, per square centimeter
- Q4112 — Cymetra, injectable, 1 cc
- Q4113 — Graftjacket xpress, injectable, 1 cc
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under Q4100
- Watch Q4100 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4100
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.