Q4186 HCPCS code: Epifix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4186 is the HCPCS Level II code for epifix, per square centimeter (add-on, list separately in addition to primary procedure). In 2024 Medicare paid an average of $120.00 per service for Q4186 across 174,978 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 50% from 2022 to 2024 (352,930 to 174,978 services). In 2024, about 1,064 clinicians billed Medicare for Q4186 for 4,034 beneficiaries; California, Illinois, Kentucky accounted for 47% of services.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | O1E — Other drugs |
| Added | 2019-01-01 |
| Last action effective | 2026-01-01 |
Who bills Q4186 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,064 |
| Medicare beneficiaries | 4,034 |
| States with claims | 31 |
| Share of services in top 3 states (California, Illinois, Kentucky) | 47% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4186, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 352,930 | 6,143 | $152.77 | $121.84 |
| 2023 | 398,854 | 6,528 | $147.84 | $117.74 |
| 2024 | 174,978 | 4,034 | $150.80 | $120.00 |
States with the most Q4186 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 48,984 | $120.03 |
| Illinois | 16,733 | $119.93 |
| Kentucky | 14,229 | $120.03 |
| Minnesota | 10,189 | $120.23 |
| Florida | 8,027 | $118.33 |
What changed for Q4186
- January 2026: Descriptor revised (Was: Epifix, per square centimeter)
- 2019-01-01: Q4186 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 Q4186?
Q4186 is the HCPCS Level II code for epifix, per square centimeter (add-on, list separately in addition to primary procedure). Short descriptor: "Epifix 1 sq cm".
How much does Medicare pay for Q4186?
In 2024, the average Medicare payment was $120.00 per service (average allowed $150.80).
Does Medicare cover Q4186?
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
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 Q4186
- Watch Q4186 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4186
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.