Q4166 HCPCS code: Cytal, per square centimeter
Q4166 is the HCPCS Level II code for cytal, per square centimeter. In 2024 Medicare paid an average of $14.05 per service for Q4166 across 5,188 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume rose 316% from 2023 to 2024 (1,246 to 5,188 services). In 2024, about 26 clinicians billed Medicare for Q4166 for 68 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 | 2017-01-01 |
| Last action effective | 2017-01-01 |
Who bills Q4166 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 26 |
| Medicare beneficiaries | 68 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4166, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 1,246 | 28 | $29.29 | $23.34 |
| 2024 | 5,188 | 68 | $17.65 | $14.05 |
States with the most Q4166 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Indiana | 1,791 | $15.05 |
| Texas | 232 | $6.21 |
What changed for Q4166
- 2017-01-01: Q4166 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 Q4166?
Q4166 is the HCPCS Level II code for cytal, per square centimeter. Short descriptor: "Cytal, per square centimeter".
How much does Medicare pay for Q4166?
In 2024, the average Medicare payment was $14.05 per service (average allowed $17.65).
Does Medicare cover Q4166?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
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- 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
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 Q4166
- Watch Q4166 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4166
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.