Q4111 HCPCS code: Gammagraft, per square centimeter
Q4111 is the HCPCS Level II code for gammagraft, per square centimeter. In 2024 Medicare paid an average of $5.51 per service for Q4111 across 62 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 83% from 2022 to 2024 (355 to 62 services). In 2024, about 2 clinicians billed Medicare for Q4111 for 16 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 | 2014-01-01 |
Who bills Q4111 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2 |
| Medicare beneficiaries | 16 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4111, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 355 | 23 | $6.91 | $5.37 |
| 2023 | 457 | 20 | $7.13 | $5.68 |
| 2024 | 62 | 16 | $7.15 | $5.51 |
States with the most Q4111 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 62 | $5.51 |
What changed for Q4111
- 2009-01-01: Q4111 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 Q4111?
Q4111 is the HCPCS Level II code for gammagraft, per square centimeter. Short descriptor: "Gammagraft".
How much does Medicare pay for Q4111?
In 2024, the average Medicare payment was $5.51 per service (average allowed $7.15).
Does Medicare cover Q4111?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q41 codes
- Q4100 — Skin substitute, not otherwise specified
- 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
- 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 Q4111
- Watch Q4111 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4111
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.