Q4209 HCPCS code: Surgraft, per square centimeter
Q4209 is the HCPCS Level II code for surgraft, per square centimeter. In 2022 Medicare paid an average of $356.24 per service for Q4209 across 2,256 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2022, about 19 clinicians billed Medicare for Q4209 for 42 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 | 2019-10-01 |
| Last action effective | 2019-10-01 |
Who bills Q4209 (2022)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 19 |
| Medicare beneficiaries | 42 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4209, 2022–2022
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,256 | 42 | $446.13 | $356.24 |
States with the most Q4209 services (2022)
| State | Services | Avg. paid |
|---|---|---|
| New York | 1,437 | $271.12 |
| New Jersey | 339 | $593.14 |
What changed for Q4209
- 2019-10-01: Q4209 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 Q4209?
Q4209 is the HCPCS Level II code for surgraft, per square centimeter. Short descriptor: "Surgraft per sq cm".
How much does Medicare pay for Q4209?
In 2022, the average Medicare payment was $356.24 per service (average allowed $446.13).
Does Medicare cover Q4209?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q42 codes
- Q4200 — Skin te, per square centimeter
- Q4201 — Matrion, per square centimeter
- Q4202 — Keroxx (2.5g/cc), 1cc
- Q4203 — Derma-gide, per square centimeter
- Q4204 — Xwrap, per square centimeter
- Q4205 — Membrane graft or membrane wrap, per square centimeter
- Q4206 — Fluid flow or fluid gf, 1 cc
- Q4208 — Novafix, per square cenitmeter
- Q4210 — Axolotl graft or axolotl dualgraft, per square centimeter
- Q4211 — Amnion bio or axobiomembrane, per square centimeter
- Q4212 — Allogen, per cc
- Q4213 — Ascent, 0.5 mg
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 Q4209
- Watch Q4209 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4209
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.