HCPCS Q4186 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Temporary Codes • Skin Substitutes and Biologicals |
| Complexity Level | Low |
| CMS | $150.33 Drug ASP |
National average reimbursement for HCPCS Q4186 by major payers:
$154.55
$171.71
$180.16
$171.78
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS Q4186 | ||||||
United | Q4186 | $158.33 | 1306364401 - WASHINGTON GASTROENTEROLOGY PLLC | 813051028 - WASHINGTON GASTROENTEROLOGY, PLLC | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1598842544 - MICHELE THOMPSON | 811726320 - (WA) MICHELE M THOMPSON MD LLC | WA | Dermatology Physician (207N00000X) |
United | Q4186 | $154.66 | 1437230786 - ROBIN HORNUNG | 813253496 | WA | Dermatology Physician (207N00000X) |
United | Q4186 | $158.33 | 1104118553 - TEJAS KIRTANE | 753186720 | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1427378082 - JENNIFER HIGA | 813051028 - WASHINGTON GASTROENTEROLOGY, PLLC | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1194704106 - VENKATACHALA MOHAN | 810233121 - ST PETERS HEALTH | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1194704106 - VENKATACHALA MOHAN | 753186720 | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1306810023 - JEREMIAH OJEABURU | 813051028 - WASHINGTON GASTROENTEROLOGY, PLLC | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1740310283 - GILBERT ONG | 814670687 - SHC MEDICAL CENTER TOPPENISH | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1588651400 - JAMES GOFF | 820380784 - KOOTENAI HEALTH INC | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $154.66 | 1124037817 - BRENDA NEWMAN | 611688913 - (WA) DERMATOLOGY CLINIC PLLC | WA | Dermatology Physician (207N00000X) |
United | Q4186 | $158.33 | 1477059442 - LAUREN BONOMO | 742592013 - (TX) DERMATOLOGY ASSOCIATES OF SAN ANTONIO | WA | Dermatology Physician (207N00000X) |
United | Q4186 | $154.66 | 1477059442 - LAUREN BONOMO | 742592013 - (TX) DERMATOLOGY ASSOCIATES OF SAN ANTONIO | WA | Dermatology Physician (207N00000X) |
United | Q4186 | $158.33 | 1265942346 - DIGESTIVE HEALTH CONSULTANTS, PLLC | 822492738 - (WA) DIGESTIVE HEALTH CONSULTANTS PLLC | WA | Gastroenterology Physician (207RG0100X) |
United | Q4186 | $158.33 | 1588749691 - CARMEN BERGER | 821149239 - (WA) ARBORETUM DERMATOLOGY SEATTLE PLLC | WA | Dermatology Physician (207N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS Q4186 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4186 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 Q4186 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.
| Code | Complexity | Description |
|---|---|---|
| Q4185-HCPCS | Low | Cellesta flowable amnion (25 mg per cc); per 0.5 cc |
| Q4186-HCPCS | Low | Epifix, per square centimeter |
| Q4187-HCPCS | Moderate | Epicord, per square centimeter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4186. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4186 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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