LCD L35041: Application of Bioengineered Skin Substitutes to Lower Extremity Chronic Non-Healing Wounds — Novitas
Dermatology
Government source· CMS / MACverify ↗HCPCS Level II code
Q4107 — Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure)
HCPCS Level IIVerified Sep 19, 2026
Medicare payment
$127.26
2026 Physician Fee Schedule · non-facility
Source: CMS Physician Fee Schedule (PPRRVU 2026). CMS fee schedules ↗ · PFS status indicator A
National amount before geographic adjustment. Your MAC's locality rate will differ.
Code definition
Code
Q4107
Code system
HCPCS Level II
Full description
Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure)
Policy activity for HCPCS Q4107
CLV Intelligence is tracking 1 policy change that cite HCPCS Q4107 most recently on 2026-09-12, drawn from 1 LCD/NCD coverage update. The changes span Dermatology.
- LCD/NCD coverage update
- 1
Counts reflect the source documents CLV has matched to HCPCS Q4107 to date; each links to the government publication that is authoritative. Monitored daily from CMS, the Federal Register, and Medicare Administrative Contractor publications.
Recent policy changes matched to Q4107
Matched to this code by CLV analysis of each policy. The linked source document is authoritative.
Audit documentation
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