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 |
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 | 1134157548 - ROBERT SHIROFF | 610458376 - PIKEVILLE MEDICAL CENTER INC | NV | Cardiovascular Disease Physician (207RC0000X) |
United | Q4280 | $3180.00 | 1992855175 - DOUGLAS FILIPOV | 820299396 - MT GRANT GENERAL HOSPITAL | NV | Emergency Medicine Physician (207P00000X) |
United | Q4280 | $2678.52 | 1770241010 - DROZDOW CHILDREN'S HEALTHCARE SERVICES OF NEVADA, P.C. | 1770241010 - (NV) DROZDOW CHILDREN'S HEALTHCARE SERVICES OF NEVADA, P.C. | NV | Neonatal-Perinatal Medicine Physician (2080N0001X) |
United | Q4280 | $2060.39 | 1649921594 - PREYA PATEL | 823338198 | NV | Registered Dietitian (133V00000X) |
United | Q4280 | $2544.00 | 1902569981 - PRISM MEDICAL PRODUCTS, L.L.C. | 1902569981 - (NV) PRISM MEDICAL PRODUCTS, L.L.C. | NV | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | Q4280 | $3180.00 | 1164095899 - ADULT HEALTH AND WELLNESS CENTER LLC | 862530919 - (NV) ADULT HEALTH AND WELLNESS CENTER LLC | NV | Family Medicine Physician (207Q00000X) |
United | Q4280 | $3180.00 | 1215346374 - ECHO MATHEWS | 886000088 | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4280 | $3180.00 | 1083607295 - MARK MUELLER | 910889551 | NV | Internal Medicine Physician (207R00000X) |
United | Q4280 | $3180.00 | 1093396467 - GIEDRE ASTRAUSKAS | 262588647 - NUTRITION IN MOTION, LLC | NV | Registered Dietitian (133V00000X) |
United | Q4280 | $3180.00 | 1902150840 - BELINDA ORDEN | 510598253 - (NV) PRITI NARULA MD PC | NV | Nurse Practitioner (363L00000X) |
United | Q4280 | $2060.39 | 1033609656 - JULIA SUNG | 263147146 - (NV) WOMEN'S HEALTH ASSOCIATES OF SOUTHERN NEVADA | NV | Physician Assistant (363A00000X) |
United | Q4280 | $2118.09 | 1619123395 - DAN-YU WANG | 954526112 | NV | Internal Medicine Physician (207R00000X) |
United | Q4280 | $2861.97 | 1487915153 - JONATHAN HAGEN | 880382265 - (NV) LAKE TAHOE ORTHOPAEDIC INSTITUTE A WATSONSWANSON PROFESSIONAL CORP | NV | Orthopaedic Surgery Physician (207X00000X) |
United | Q4280 | $2862.00 | 1407383904 - ROMMEL DE VERA | 1407383904 - (NV) ROMMEL DE VERA | NV | Family Medicine Physician (207Q00000X) |
United | Q4280 | $3180.00 | 1225509961 - ERIN DAVIES | 481267451 - (NV) WEE CARE PEDIATRICS | NV | Pediatric Nurse Practitioner (363LP0200X) |
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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