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HCPCS Q4107 Fee Schedule

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure)
Key FactDetail
Service Type

Temporary Codes

Skin Substitutes and Biologicals

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for Q4107

National average reimbursement for HCPCS Q4107 by major payers:

bcbs

$93.89

uhc

$138.19

aetna

$91.03

cigna

$92.66

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS Q4107.

HCPCS Q4107
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $300.23Published rate
  2. Northside Hospital, Inc., Northside Hospital Duluth

    GAGeneral Acute Care HospitalNPI 1790715381Tax ID 58-2002413

    $144.66Published rate
  3. Cindy Chang

    Miguel A Arenas Md PC

    AZFamily Nurse PractitionerNPI 1316561236Tax ID 30-0394179

    $136.47Published rate
  4. Brooke Caldwell

    Attigo Infusion Inc

    TXAdult Health Nurse PractitionerNPI 1043785744Tax ID 84-3505937

    $136.47Published rate
  5. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $92.59Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS Q4107 vs. Other Skin Substitutes and Biologicals Codes

The HCPCS Q4107 code is part of the Temporary Codes services used for Skin Substitutes and Biologicals. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS Q4107 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
Q4107-HCPCSLowGraftjacket, per square centimeter (add-on, list separately in addition to primary procedure)
Q4108-HCPCSLowIntegra matrix, per square centimeter (add-on, list separately in addition to primary procedure)

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4107. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the Q4107 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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