Q4191 HCPCS code: Restorigin, per square centimeter (add-on, list separately in addition to primary procedure)
Q4191 is the HCPCS Level II code for restorigin, per square centimeter (add-on, list separately in addition to primary procedure). In 2024 Medicare paid an average of $1,180.44 per service for Q4191 across 493,817 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume rose 6094% from 2022 to 2024 (7,973 to 493,817 services). In 2024, about 1,089 clinicians billed Medicare for Q4191 for 5,298 beneficiaries; California, Florida, Texas accounted for 61% 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 Q4191 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,089 |
| Medicare beneficiaries | 5,298 |
| States with claims | 33 |
| Share of services in top 3 states (California, Florida, Texas) | 61% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4191, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 7,973 | 65 | $483.03 | $385.16 |
| 2023 | 3,266 | 43 | $737.94 | $588.15 |
| 2024 | 493,817 | 5,298 | $1,481.63 | $1,180.44 |
States with the most Q4191 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 174,895 | $1,178.35 |
| Florida | 62,183 | $1,181.89 |
| Texas | 58,705 | $1,197.90 |
| Illinois | 25,287 | $1,166.79 |
| Arizona | 21,935 | $1,186.82 |
What changed for Q4191
- January 2026: Descriptor revised (Was: Restorigin, per square centimeter)
- 2019-01-01: Q4191 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 Q4191?
Q4191 is the HCPCS Level II code for restorigin, per square centimeter (add-on, list separately in addition to primary procedure). Short descriptor: "Restorigin 1 sq cm".
How much does Medicare pay for Q4191?
In 2024, the average Medicare payment was $1,180.44 per service (average allowed $1,481.63).
Does Medicare cover Q4191?
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 Q4191
- Watch Q4191 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4191
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.