Coding: Browse HCPCS Level II 2020 Edition

Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

Q4100 - Q4204 Skin Substitutes (CMS Temporary Codes)

Q4100

Skin substitute, not otherwise specified

short

Skin substitute, nos

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4101

Apligraf, per square centimeter

short

Apligraf

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4102

Oasis wound matrix, per square centimeter

short

Oasis wound matrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4103

Oasis burn matrix, per square centimeter

short

Oasis burn matrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

MUE

Location	Value	Ajudication Indicator	Rationale
PRA	0.0	3 Date of Service Edit: Clinical	Drug discontinued
OPH	0.0	3 Date of Service Edit: Clinical	Drug discontinued

Q4104

Integra bilayer matrix wound dressing (bmwd), per square centimeter

short

Integra bmwd

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4105

Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter

short

Integra drt or omnigraft

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4106

Dermagraft, per square centimeter

short

Dermagraft

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4107

Graftjacket, per square centimeter

short

Graftjacket

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4108

Integra matrix, per square centimeter

short

Integra matrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4110

Primatrix, per square centimeter

short

Primatrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4111

Gammagraft, per square centimeter

short

Gammagraft

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4112

Cymetra, injectable, 1 cc

short

Cymetra injectable

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4113

Graftjacket xpress, injectable, 1 cc

short

Graftjacket xpress

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4114

Integra flowable wound matrix, injectable, 1 cc

short

Integra flowable wound matri

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4115

Alloskin, per square centimeter

short

Alloskin

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4116

Alloderm, per square centimeter

short

Alloderm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4117

Hyalomatrix, per square centimeter

short

Hyalomatrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4118

Matristem micromatrix, 1 mg

short

Matristem micromatrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4119

Matristem wound matrix, per square centimeter

short

Matristem wound matrix

Q4120

Matristem burn matrix, per square centimeter

short

Matristem burn matrix

Q4121

Theraskin, per square centimeter

short

Theraskin

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4122

Dermacell, dermacell awm or dermacell awm porous, per square centimeter

short

Dermacell, awm, porous sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4123

Alloskin rt, per square centimeter

short

Alloskin

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4124

Oasis ultra tri-layer wound matrix, per square centimeter

short

Oasis tri-layer wound matrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4125

Arthroflex, per square centimeter

short

Arthroflex

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4126

Memoderm, dermaspan, tranzgraft or integuply, per square centimeter

short

Memoderm/derma/tranz/integup

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4127

Talymed, per square centimeter

short

Talymed

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4128

Flex hd, allopatch hd, or matrix hd, per square centimeter

short

Flexhd/allopatchhd/matrixhd

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4129

Unite biomatrix, per square centimeter

short

Unite biomatrix

Q4130

Strattice tm, per square centimeter

short

Strattice tm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4131

Epifix or epicord, per square centimeter

short

Epifix or epicord

Q4132

Grafix core and grafixpl core, per square centimeter

short

Grafix core, grafixpl core

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4133

Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter

short

Grafix stravix prime pl sqcm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4134

Hmatrix, per square centimeter

short

Hmatrix

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4135

Mediskin, per square centimeter

short

Mediskin

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4136

Ez-derm, per square centimeter

short

Ezderm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4137

Amnioexcel, amnioexcel plus or biodexcel, per square centimeter

short

Amnioexcel biodexcel 1sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4138

Biodfence dryflex, per square centimeter

short

Biodfence dryflex, 1cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4139

Amniomatrix or biodmatrix, injectable, 1 cc

short

Amnio or biodmatrix, inj 1cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4140

Biodfence, per square centimeter

short

Biodfence 1cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4141

Alloskin ac, per square centimeter

short

Alloskin ac, 1 cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4142

Xcm biologic tissue matrix, per square centimeter

short

Xcm biologic tiss matrix 1cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4143

Repriza, per square centimeter

short

Repriza, 1cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4145

Epifix, injectable, 1 mg

short

Epifix, inj, 1mg

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4146

Tensix, per square centimeter

short

Tensix, 1cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4147

Architect, architect px, or architect fx, extracellular matrix, per square centimeter

short

Architect ecm px fx 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4148

Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter

short

Neox neox rt or clarix cord

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4149

Excellagen, 0.1 cc

short

Excellagen, 0.1 cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4150

Allowrap ds or dry, per square centimeter

short

Allowrap ds or dry 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4151

Amnioband or guardian, per square centimeter

short

Amnioband, guardian 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4152

Dermapure, per square centimeter

short

Dermapure 1 square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4153

Dermavest and plurivest, per square centimeter

short

Dermavest, plurivest sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4154

Biovance, per square centimeter

short

Biovance 1 square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4155

Neoxflo or clarixflo, 1 mg

short

Neoxflo or clarixflo 1 mg

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4156

Neox 100 or clarix 100, per square centimeter

short

Neox 100 or clarix 100

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4157

Revitalon, per square centimeter

short

Revitalon 1 square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4158

Kerecis omega3, per square centimeter

short

Kerecis omega3, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4159

Affinity, per square centimeter

short

Affinity1 square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4160

Nushield, per square centimeter

short

Nushield 1 square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4161

Bio-connekt wound matrix, per square centimeter

short

Bio-connekt per square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4162

Woundex flow, bioskin flow, 0.5 cc

short

Wndex flw, bioskn flw, 0.5cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4163

Woundex, bioskin, per square centimeter

short

Woundex, bioskin, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4164

Helicoll, per square centimeter

short

Helicoll, per square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4165

Keramatrix or kerasorb, per square centimeter

short

Keramatrix, kerasorb sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4166

Cytal, per square centimeter

short

Cytal, per square centimeter

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4167

Truskin, per square centimeter

short

Truskin, per sq centimeter

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4168

Amnioband, 1 mg

short

Amnioband, 1 mg

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4169

Artacent wound, per square centimeter

short

Artacent wound, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4170

Cygnus, per square centimeter

short

Cygnus, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4171

Interfyl, 1 mg

short

Interfyl, 1 mg

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4172

Puraply or puraply am, per square centimeter

short

Puraply or puraply am

Q4173

Palingen or palingen xplus, per square centimeter

short

Palingen or palingen xplus

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4174

Palingen or promatrx, 0.36 mg per 0.25 cc

short

Palingen or promatrx

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4175

Miroderm, per square centimeter

short

Miroderm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4176

Neopatch, per square centimeter

short

Neopatch, per sq centimeter

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4177

Floweramnioflo, 0.1 cc

short

Floweramnioflo, 0.1 cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4178

Floweramniopatch, per square centimeter

short

Floweramniopatch, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4179

Flowerderm, per square centimeter

short

Flowerderm, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4180

Revita, per square centimeter

short

Revita, per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4181

Amnio wound, per square centimeter

short

Amnio wound, per square cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4182

Transcyte, per square centimeter

short

Transcyte, per sq centimeter

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4183

Surgigraft, per square centimeter

short

Surgigraft, 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4184

Cellesta or cellesta duo, per square centimeter

short

Cellesta or duo per sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4185

Cellesta flowable amnion (25 mg per cc); per 0.5 cc

short

Cellesta flowab amnion 0.5cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4186

Epifix, per square centimeter

short

Epifix 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4187

Epicord, per square centimeter

short

Epicord 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4188

Amnioarmor, per square centimeter

short

Amnioarmor 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4189

Artacent ac, 1 mg

short

Artacent ac, 1 mg

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4190

Artacent ac, per square centimeter

short

Artacent ac 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4191

Restorigin, per square centimeter

short

Restorigin 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4192

Restorigin, 1 cc

short

Restorigin, 1 cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4193

Coll-e-derm, per square centimeter

short

Coll-e-derm 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4194

Novachor, per square centimeter

short

Novachor 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4195

Puraply, per square centimeter

short

Puraply 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4196

Puraply am, per square centimeter

short

Puraply am 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4197

Puraply xt, per square centimeter

short

Puraply xt 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4198

Genesis amniotic membrane, per square centimeter

short

Genesis amnio membrane 1sqcm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4200

Skin te, per square centimeter

short

Skin te 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4201

Matrion, per square centimeter

short

Matrion 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4202

Keroxx (2.5g/cc), 1cc

short

Keroxx (2.5g/cc), 1cc

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4203

Derma-gide, per square centimeter

short

Derma-gide, 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX

Q4204

Xwrap, per square centimeter

short

Xwrap 1 sq cm

RVU

CPT Modifier	Physician Component	Facility Practice	Nonfacility Practice	Professional Liability Insurance	Total Facility	Total Nonfacility	Global Period
	0.0	0.0	0.0	0.0	0.0	0.0	XXX