HCPCS Q4280 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Temporary Codes • Skin Substitutes and Biologicals |
| Complexity Level | High |
| CMS | $3,246.05 Drug ASP |
National average reimbursement for HCPCS Q4280 by major payers:
$1,431.00
$2,060.40
$3,180.00
$2,892.85
| 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 Q4280 | ||||||
United | Q4280 | $2060.39 | 1861590531 - TIMOTHY TULPPO | 880103557 - (NV) RENO ORTHOPEDIC CENTER | NV | Physical Therapist (225100000X) |
United | Q4280 | $2060.39 | 1548094782 - BRITNEY SIMANEK | 481267451 - (NV) WEE CARE PEDIATRICS | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4280 | $2060.39 | 1629476114 - ROBERT ERICKSON | 880310956 - ROBERT B. MCBEATH, M.D., P.C. | NV | Certified Registered Nurse Anesthetist (367500000X) |
United | Q4280 | $2862.00 | 1407383904 - ROMMEL DE VERA | 1407383904 - (NV) ROMMEL DE VERA | NV | Family Medicine Physician (207Q00000X) |
United | Q4280 | $2060.39 | 1497146294 - STARLITA MOSS | 880332635 - (NV) WONG & LITCHFIELD, LTD. DBA DESERT ENDOCRINOLOGY | NV | Physician Assistant (363A00000X) |
United | Q4280 | $3180.00 | 1659569929 - SHALONDA MYLES | 394801385 | NV | Nurse Practitioner (363L00000X) |
United | Q4280 | $3180.00 | 1841226636 - YUAN-CHUNG CHEN | 880444678 - (NV) PHIL Y C CHEN DO A PROFESSIONAL CORPORATION | NV | Family Medicine Physician (207Q00000X) |
United | Q4280 | $2118.09 | 1619123395 - DAN-YU WANG | 954526112 | NV | Internal Medicine Physician (207R00000X) |
United | Q4280 | $2060.39 | 1972685212 - RANDAL PEOPLES | 452473070 - (NV) DIGNITY HEALTH | NV | Neurological Surgery Physician (207T00000X) |
United | Q4280 | $3180.00 | 1578204657 - BRIAN DOUGLAS | 205244843 - (NV) BERMAN & PITMAN, LTD. | NV | Medical Physician Assistant (363AM0700X) |
United | Q4280 | $3180.00 | 1013172535 - BRIAN GILMER | 270028866 - (NV) JAMES J LYNCH MD LTD DBA SPINENEVADA | NV | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | Q4280 | $2060.39 | 1881670313 - DRS O'GARA, CAPURRO, & ZAMBONI, ET AL RALSTON MEDICAL LTD, RALSTON MEDICAL LTD | 880459017 - (NV) DRS OGARA CAPURRO AND ZAMBONI ET AL RALSTON MEDICAL LTD | NV | Family Medicine Physician (207Q00000X) |
United | Q4280 | $2307.64 | 1962674150 - HUMAIRA MOJADADDI | 453089947 - (CA) ARYA MEDICAL GROUP CORP | NV | Hospitalist Physician (208M00000X) |
United | Q4280 | $3180.00 | 1992855175 - DOUGLAS FILIPOV | 820299396 - MT GRANT GENERAL HOSPITAL | NV | Emergency Medicine Physician (207P00000X) |
United | Q4280 | $3180.00 | 1205034832 - LAWRENCE HUFF | 834125142 - (NV) ONV CARE OF NV LLC | NV | Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X) |
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 Q4280 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4280 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 Q4280 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 |
|---|---|---|
| Q4278-HCPCS | Moderate | Epieffect, per square centimeter |
| Q4280-HCPCS | High | Xcell amnio matrix, per square centimeter |
| Q4281-HCPCS | Moderate | Barrera sl or barrera dl, 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 Q4280. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4280 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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