Q4174 HCPCS code: Palingen or promatrx, 0.36 mg per 0.25 cc
Q4174 is the HCPCS Level II code for palingen or promatrx, 0.36 mg per 0.25 cc. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 13 |
| BETOS category | O1E — Other drugs |
| Added | 2017-01-01 |
| Last action effective | 2026-01-01 |
Medicare policy articles for this code
- A58865: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A58883: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Palmetto GBA (MAC - Part A, MAC - Part B))
- A58893: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A59374: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A59434: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A59434: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A59764: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
- A59766: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
What changed for Q4174
- 2017-01-01: Q4174 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 Q4174?
Q4174 is the HCPCS Level II code for palingen or promatrx, 0.36 mg per 0.25 cc. Short descriptor: "Palingen or promatrx".
Does Medicare cover Q4174?
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 (add-on, list separately in addition to primary procedure)
- Q4102 — Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4103 — Oasis burn matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4104 — Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure)
- Q4105 — Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4106 — Dermagraft, per square centimeter
- Q4107 — Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4108 — Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4110 — Primatrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4111 — Gammagraft, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4112 — Cymetra, injectable, 1 cc
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Next steps
- Run a reimbursement report for a device billed under Q4174
- Watch Q4174 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4174
Sources: CMS HCPCS Level II release October 2026; 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.