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See a sample rate comparisonHCPCS Q4259 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Temporary Codes Skin Substitutes and Biologicals |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for Q4259 |
National average reimbursement for HCPCS Q4259 by major payers:
$1,045.87
$1,316.29
$1,318.55
$1,365.24
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HCPCS Q4259
5 of 25 sample ratesHigher to lower in this preview
Northside Hospital, Inc., Northside Hospital Forsyth
Northside Hospital Inc
$2,959.68Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$1,334.34Published rateVictoria Lewis-Holland
$1,280.73Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$997.70Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$880.65Published rate
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See a sample payer proposalHCPCS Q4259 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4259 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 Q4259 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 |
|---|---|---|
| Q4258-HCPCS | Low | Enverse, per square centimeter (add-on, list separately in addition to primary procedure) |
| Q4259-HCPCS | High | Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure) |
| Q4260-HCPCS | Low | Signature apatch, 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 Q4259. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4259 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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