Q4101 HCPCS code: Apligraf, per square centimeter
Q4101 is the HCPCS Level II code for apligraf, per square centimeter. In 2024 Medicare paid an average of $23.62 per service for Q4101 across 34,513 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 40% from 2022 to 2024 (57,844 to 34,513 services). In 2024, about 189 clinicians billed Medicare for Q4101 for 246 beneficiaries; New York, Wisconsin, Florida accounted for 63% of services.
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 | 2014-01-01 |
Who bills Q4101 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 189 |
| Medicare beneficiaries | 246 |
| States with claims | 7 |
| Share of services in top 3 states (New York, Wisconsin, Florida) | 63% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4101, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 57,844 | 446 | $29.31 | $23.37 |
| 2023 | 47,810 | 364 | $28.70 | $22.86 |
| 2024 | 34,513 | 246 | $29.64 | $23.62 |
States with the most Q4101 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 5,053 | $23.88 |
| Wisconsin | 3,213 | $23.97 |
| Florida | 2,671 | $23.93 |
| New Jersey | 2,247 | $23.63 |
| Virginia | 1,725 | $23.91 |
What changed for Q4101
- 2009-01-01: Q4101 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 Q4101?
Q4101 is the HCPCS Level II code for apligraf, per square centimeter. Short descriptor: "Apligraf".
How much does Medicare pay for Q4101?
In 2024, the average Medicare payment was $23.62 per service (average allowed $29.64).
Does Medicare cover Q4101?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q41 codes
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- 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 Q4101
- Watch Q4101 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4101
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.