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HCPCS Q4157 Fee Schedule

Last Verified: September 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.

Revitalon, 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 Q4157

National average reimbursement for HCPCS Q4157 by major payers:

bcbs

$100.75

uhc

$205.89

aetna

$176.63

cigna

$179.56

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS Q4157.

HCPCS Q4157
5 of 25 sample ratesHigher to lower in this preview
  1. The Medical Center Inc, Piedmont Columbus Regional Midtown

    The Medical Center Inc

    GAGeneral Acute Care HospitalNPI 1255401519Tax ID 58-1685139

    $771.53Published rate
  2. Marc Stiefel

    Pinnacle Ent Alliance, LLC

    PAOtolaryngology PhysicianNPI 1578583647Tax ID 20-2604678

    $202.90Published rate
  3. Aztec Urgent Care, LLC

    Aztec Urgent Care LLC

    NMUrgent Care Clinic/CenterNPI 1063741163Tax ID 27-1495988

    $202.89Published rate
  4. Professional Resources Management Of Rabun, LLC, Mountain Lakes Medical Center

    GACritical Access HospitalNPI 1326191180Tax ID 20-2012765

    $202.89Published rate
  5. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $178.13Published rate

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

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HCPCS Q4157 vs. Other Skin Substitutes and Biologicals Codes

The HCPCS Q4157 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 Q4157 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
Q4156-HCPCSLowNeox 100 or clarix 100, per square centimeter (add-on, list separately in addition to primary procedure)
Q4157-HCPCSLowRevitalon, per square centimeter (add-on, list separately in addition to primary procedure)
Q4158-HCPCSLowKerecis omega3, 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 Q4157. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the Q4157 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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