HCPCS Q4274 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 | Moderate |
| CMS | $1,838.29 Drug ASP |
National average reimbursement for HCPCS Q4274 by major payers:
$551.63
$1,538.27
$1,242.25
$1,259.64
| 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 Q4274 | ||||||
United | Q4274 | $1828.25 | 1225031750 - JASPER HEALTH SERVICES, INC., JASPER MEMORIAL HOSPITAL | 582510435 - (GA) JASPER HEALTH SERVICES INC | GA | Critical Access Hospital (282NC0060X) |
United | Q4274 | $1828.25 | 1215647706 - SONYA REYES | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1699050633 - DONNA FLEMING | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1306136551 - UJUKA ILOABUCHI | 582422542 - ATLANTA WOMENS HEALTH GROUP, P.C. | GA | Women's Hospital (282NW0100X) |
United | Q4274 | $1828.25 | 1780799015 - DALE YOO | 843505937 - (TX) ATTIGO INFUSION INC | TX | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | Q4274 | $1828.25 | 1730952714 - ASHLEY MATHIS | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1376541755 - THOMAS WATSON | 843505937 - (TX) ATTIGO INFUSION INC | TX | Anesthesiology Physician (207L00000X) |
United | Q4274 | $1828.25 | 1881179588 - MARY EZEBUIRO | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1316944903 - ROBERT CARO | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Medicine Physician (207Q00000X) |
United | Q4274 | $1828.25 | 1386373306 - FE ANN BRAXTON | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1558072959 - ELEN ERAPURAM | 843505937 - (TX) ATTIGO INFUSION INC | TX | Nurse Practitioner (363L00000X) |
United | Q4274 | $1828.25 | 1174237986 - ANDREA SANCHEZ | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1720687858 - KIMBERLEY LANDRY | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Nurse Practitioner (363LF0000X) |
United | Q4274 | $1828.25 | 1821292517 - STEVEN CLARK | 843505937 - (TX) ATTIGO INFUSION INC | TX | Plastic and Reconstructive Surgery Physician (2086S0122X) |
United | Q4274 | $1828.25 | 1316944903 - ROBERT CARO | 843505937 - (TX) ATTIGO INFUSION INC | TX | Family Medicine Physician (207Q00000X) |
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 Q4274 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4274 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 Q4274 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 |
|---|---|---|
| Q4273-HCPCS | Low | Esano aaa, per square centimeter |
| Q4274-HCPCS | Moderate | Esano ac, per square centimeter |
| Q4275-HCPCS | Moderate | Esano aca, 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 Q4274. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4274 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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