Q4254 HCPCS code: Novafix dl, per square centimeter
Q4254 is the HCPCS Level II code for novafix dl, per square centimeter. In 2022 Medicare paid an average of $395.43 per service for Q4254 across 29,479 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2022, about 155 clinicians billed Medicare for Q4254 for 472 beneficiaries; Louisiana, Texas, Tennessee accounted for 76% of services.
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 | 2020-10-01 |
| Last action effective | 2020-10-01 |
Who bills Q4254 (2022)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 155 |
| Medicare beneficiaries | 472 |
| States with claims | 7 |
| Share of services in top 3 states (Louisiana, Texas, Tennessee) | 76% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4254, 2022–2022
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 29,479 | 472 | $495.04 | $395.43 |
States with the most Q4254 services (2022)
| State | Services | Avg. paid |
|---|---|---|
| Louisiana | 12,011 | $392.94 |
| Texas | 4,866 | $402.55 |
| Tennessee | 3,746 | $402.24 |
| Mississippi | 2,608 | $393.36 |
| Florida | 1,838 | $389.87 |
What changed for Q4254
- 2020-10-01: Q4254 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 Q4254?
Q4254 is the HCPCS Level II code for novafix dl, per square centimeter. Short descriptor: "Novafix dl per sq cm".
How much does Medicare pay for Q4254?
In 2022, the average Medicare payment was $395.43 per service (average allowed $495.04).
Does Medicare cover Q4254?
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
- Q4209 — Surgraft, per square centimeter
- Q4210 — Axolotl graft or axolotl dualgraft, per square centimeter
- Q4211 — Amnion bio or axobiomembrane, per square centimeter
- Q4212 — Allogen, per 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 Q4254
- Watch Q4254 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4254
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.