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HCPCS Procedure & Supply Codes

Temporary Codes

section notes

Skin Substitutes

section notes
Q4100   Skin substitute, not otherwise specified
Q4101   Apligraf, per square centimeter
Q4102   Oasis wound matrix, per square centimeter
Q4103   Oasis burn matrix, per square centimeter
Q4104   Integra bilayer matrix wound dressing (bmwd), per square centimeter
Q4105   Integra dermal regeneration template (drt) or integra omnigraft dermal regenerat...
Q4106   Dermagraft, per square centimeter
Q4107   Graftjacket, per square centimeter
Q4108   Integra matrix, per square centimeter
Q4110   Primatrix, per square centimeter
Q4111   Gammagraft, per square centimeter
Q4112   Cymetra, injectable, 1 cc
Q4113   Graftjacket xpress, injectable, 1 cc
Q4114   Integra flowable wound matrix, injectable, 1 cc
Q4115   Alloskin, per square centimeter
Q4116   Alloderm, per square centimeter
Q4117   Hyalomatrix, per square centimeter
Q4118   Matristem micromatrix, 1 mg
Q4121   Theraskin, per square centimeter
Q4122   Dermacell, dermacell awm or dermacell awm porous, per square centimeter
Q4123   Alloskin rt, per square centimeter
Q4124   Oasis ultra tri-layer wound matrix, per square centimeter
Q4125   Arthroflex, per square centimeter
Q4126   Memoderm, dermaspan, tranzgraft or integuply, per square centimeter
Q4127   Talymed, per square centimeter
Q4128   Flex hd, or allopatch hd, per square centimeter
Q4130   Strattice tm, per square centimeter
Q4132   Grafix core and grafixpl core, per square centimeter
Q4133   Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter
Q4134   Hmatrix, per square centimeter
Q4135   Mediskin, per square centimeter
Q4136   Ez-derm, per square centimeter
Q4137   Amnioexcel, amnioexcel plus or biodexcel, per square centimeter
Q4138   Biodfence dryflex, per square centimeter
Q4139   Amniomatrix or biodmatrix, injectable, 1 cc
Q4140   Biodfence, per square centimeter
Q4141   Alloskin ac, per square centimeter
Q4142   Xcm biologic tissue matrix, per square centimeter
Q4143   Repriza, per square centimeter
Q4145   Epifix, injectable, 1 mg
Q4146   Tensix, per square centimeter
Q4147   Architect, architect px, or architect fx, extracellular matrix, per square centimeter
Q4148   Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter
Q4149   Excellagen, 0.1 cc
Q4150   Allowrap ds or dry, per square centimeter
Q4151   Amnioband or guardian, per square centimeter
Q4152   Dermapure, per square centimeter
Q4153   Dermavest and plurivest, per square centimeter
Q4154   Biovance, per square centimeter
Q4155   Neoxflo or clarixflo, 1 mg
Q4156   Neox 100 or clarix 100, per square centimeter
Q4157   Revitalon, per square centimeter
Q4158   Kerecis omega3, per square centimeter
Q4159   Affinity, per square centimeter
Q4160   Nushield, per square centimeter
Q4161   Bio-connekt wound matrix, per square centimeter
Q4162   Woundex flow, bioskin flow, 0.5 cc
Q4163   Woundex, bioskin, per square centimeter
Q4164   Helicoll, per square centimeter
Q4165   Keramatrix or kerasorb, per square centimeter
Q4166   Cytal, per square centimeter
Q4167   Truskin, per square centimeter
Q4168   Amnioband, 1 mg
Q4169   Artacent wound, per square centimeter
Q4170   Cygnus, per square centimeter
Q4171   Interfyl, 1 mg
Q4173   Palingen or palingen xplus, per square centimeter
Q4174   Palingen or promatrx, 0.36 mg per 0.25 cc
Q4175   Miroderm, per square centimeter
Q4176   Neopatch or therion, per square centimeter
Q4177   Floweramnioflo, 0.1 cc
Q4178   Floweramniopatch, per square centimeter
Q4179   Flowerderm, per square centimeter
Q4180   Revita, per square centimeter
Q4181   Amnio wound, per square centimeter
Q4182   Transcyte, per square centimeter
Q4183   Surgigraft, per square centimeter
Q4184‑Q4187   Cellesta
Q4188   Amnioarmor, per square centimeter
Q4189‑Q4216   Artacent
Q4191‑Q4192   Restorigin
Q4193   Coll-e-derm, per square centimeter
Q4194   Novachor, per square centimeter
Q4195‑Q4197   Puraply
Q4198   Genesis amniotic membrane, per square centimeter
Q4199   Cygnus matrix, per square centimeter
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
Q4213   Ascent, 0.5 mg
Q4214   Cellesta cord, per square centimeter
Q4215   Axolotl ambient or axolotl cryo, 0.1 mg
Q4217   Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xpl...
Q4218   Surgicord, per square centimeter
Q4219   Surgigraft-dual, per square centimeter
Q4220   Bellacell hd or surederm, per square centimeter
Q4221   Amniowrap2, per square centimeter
Q4222   Progenamatrix, per square centimeter
Q4224   Human health factor 10 amniotic patch (hhf10-p), per square centimeter
Q4225   Amniobind, per square centimeter
Q4226   Myown skin, includes harvesting and preparation procedures, per square centimeter
Q4227   Amniocore, per square centimeter
Q4229   Cogenex amniotic membrane, per square centimeter
Q4230   Cogenex flowable amnion, per 0.5 cc
Q4231   Corplex p, per cc
Q4232   Corplex, per square centimeter
Q4233   Surfactor or nudyn, per 0.5 cc
Q4234   Xcellerate, per square centimeter
Q4235   Amniorepair or altiply, per square centimeter
Q4237   Cryo-cord, per square centimeter
Q4238   Derm-maxx, per square centimeter
Q4239   Amnio-maxx or amnio-maxx lite, per square centimeter
Q4240   Corecyte, for topical use only, per 0.5 cc
Q4241   Polycyte, for topical use only, per 0.5 cc
Q4242   Amniocyte plus, per 0.5 cc
Q4244   Procenta, per 200 mg
Q4245   Amniotext, per cc
Q4246   Coretext or protext, per cc
Q4247   Amniotext patch, per square centimeter
Q4248   Dermacyte amniotic membrane allograft, per square centimeter
Q4249   Amniply, for topical use only, per square centimeter
Q4250   Amnioamp-mp, per square centimeter
Q4251   Vim, per square centimeter
Q4252   Vendaje, per square centimeter
Q4253   Zenith amniotic membrane, per square centimeter
Q4254   Novafix dl, per square centimeter
Q4255   Reguard, for topical use only, per square centimeter
Q4256   Mlg-complete, per square centimeter
Q4257   Relese, per square centimeter
Q4258   Enverse, per square centimeter
Q4259   Celera dual layer or celera dual membrane, per square centimeter
Q4260   Signature apatch, per square centimeter
Q4261   Tag, per square centimeter
Q4262   Dual layer impax membrane, per square centimeter
Q4263   Surgraft tl, per square centimeter
Q4264   Cocoon membrane, per square centimeter
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