HCPCS Q4343 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 |
National average reimbursement for HCPCS Q4343 by major payers:
$544.93
$1,381.00
$1,248.15
$1,402.26
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | Q4343 | $1920.94 | 1851153027 - ASPIRE MEDICAL CENTER LLC | 990845798 - (NV) ASPIRE MEDICAL CENTER LLC | NV | Family Medicine Physician (207Q00000X) |
United | Q4343 | $1920.94 | 1104841824 - ROBERT ROLLINS | 880176637 - (NV) WM N EVANS M D LTD DBA CHILDRENS HEART CENTER | NV | Pediatric Cardiology Physician (2080P0202X) |
United | Q4343 | $2785.00 | 1679159461 - NABEAL AMER | 1679159461 | NV | Family Medicine Physician (207Q00000X) |
United | Q4343 | $2868.55 | 1073824900 - GUY JONES | 208628418 - (NV) UROLOGY NEVADA, LTD. | NV | Radiation Oncology Physician (2085R0001X) |
United | Q4343 | $1920.94 | 1285364182 - ADVANCED SURGICAL CARE PLLC | 882259613 - (NV) ADVANCED SURGICAL CARE PLLC | NV | Surgery Physician (208600000X) |
United | Q4343 | $1920.94 | 1336257153 - ADITI SANATINIA | 270024561 - (NV) WOMEN'S SPECIALTY CARE, LLP | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | Q4343 | $1920.94 | 1467535583 - THOMAS GREEN | 870666144 - (UT) DESERET PEAK ANESTHESIA LLC | NV | Certified Registered Nurse Anesthetist (367500000X) |
United | Q4343 | $1920.94 | 1144783952 - ANDREA KESSLER | 873087632 - (AZ) CURATIVE SPECIALTY CARE LLC | NV | Nurse Practitioner (363L00000X) |
United | Q4343 | $1988.18 | 1710985700 - PATRICIA CASE | 593443182 - WOMENS CARE FLORIDA, LLP | NV | Advanced Practice Midwife (367A00000X) |
United | Q4343 | $1920.94 | 1326036005 - LATA SHETE | 880168054 | NV | Nephrology Physician (207RN0300X) |
United | Q4343 | $1920.94 | 1710075437 - SIERRA NEVADA ENT ASSOCIATES LTD, SIERRA NEVADA ENT ASSOCIATES LTD | 680405220 - (NV) SIERRA NEVADA ENT ASSOCIATES | NV | Otolaryngology Physician (207Y00000X) |
United | Q4343 | $1920.94 | 1811682396 - MARCELLA CASTILLO | 200562668 - (NV) NEVADA HEART & VASCULAR CENTER, LLP | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4343 | $1920.94 | 1104998137 - DANIEL MADSEN | 920269429 | NV | Diagnostic Radiology Physician (2085R0202X) |
United | Q4343 | $2868.55 | 1831662717 - SHEPARD URBAHN | 452888626 - (NV) COMPREHENSIVE AND INTERVENTIONAL PAIN MANAGEMENT LLP | NV | Physician Assistant (363A00000X) |
United | Q4343 | $1920.94 | 1942692124 - KATHERINA CHAPPELL | 813253496 | NV | Physician Assistant (363A00000X) |
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 Q4343 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4343 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 Q4343 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 |
|---|---|---|
| Q4343-HCPCS | Moderate | Dermacyte ac matrix amniotic membrane allograft, 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 Q4343. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4343 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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