HCPCS Q4101
Apligraf
No national payment amount
Status E is not separately payable under the PFS.
Did Medicare pay separately for HCPCS Q4101 in Q2 2025?
Not at a published national rate. HCPCS Q4101 carries status E (excluded) in the Q2 2025 release. A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. Treat the blank amount as unpriced, not as $0.
Common questions
Why is there no payment amount for Q4101?
Its status indicator is E (excluded). A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. The blank is deliberate: the amount is either unknown or paid under another provision, so reading it as $0 would be wrong.
Why would a Medicare claim for Q4101 be denied or paid less?
Each item below comes from a CMS indicator on this page — not general billing advice.
- Its status indicator is E (excluded) — A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. See status indicators
Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.
When does this rate change?
CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Saw this code on your bill?
What is a Q4101 visit in patient-friendly terms?
In plain terms: Apligraf You'll typically see HCPCS Q4101 on a bill or explanation of benefits (EOB) when a clinician performs or bills for this service.
How this amount is computed
amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.
| Component | RVU |
|---|---|
| Work RVU | blank |
| Practice expense RVU (non-facility) | blank |
| Practice expense RVU (facility) | blank |
| Malpractice RVU | blank |
Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.
Rate history by release
National non-facility amount for Q4101 across quarterly releases. Unchanged since Q1 2026 · high $127.26 in Q1 2026
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q3 2026 Jun 30, 2026 – present | A | $127.26 (0.0%) | $127.26 (0.0%) |
| Q2 2026 Mar 10, 2026 – Jun 29, 2026 | A | $127.26 (0.0%) | $127.26 (0.0%) |
| Q1 2026 Dec 29, 2025 – Mar 9, 2026 | A | $127.26 | $127.26 |
| Q4 2025 Sep 11, 2025 – Dec 28, 2025 | E | — | — |
| Q3 2025 Jun 5, 2025 – Sep 10, 2025 | E | — | — |
| Q2 2025 Jun 5, 2025 – Jun 4, 2025 | E | — | — |
| Q1 2025 Dec 23, 2024 – Jun 4, 2025 | E | — | — |
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Source & method
This is computed from CMS's Medicare Physician Fee Schedule Q2 2025 release (schedule pfs, effective April 2025). National amounts apply a GPCI of 1.000 and leave sequestration off. The status indicator decides payability, never the RVU values, so a blank RVU stays blank. Releases are immutable: a rate retrieved for a past quarter always reflects that release. CMS owns the code description shown for HCPCS Level II codes. Commercial and cash-pay figures anywhere on this page are arithmetic on the Medicare amount, using commonly cited reimbursement ranges. They're illustrative, and no nationwide claims database stands behind them.
Conversion factor $32.3465 read from the same file, row 11, column 25.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
This link keeps pointing at the Q2 2025 figures, even after a newer release lands.
HCPCS Q4101 Medicare Physician Fee Schedule rate (Q2 2025). Localis. https://localishealth.com/hcpcs/Q4101/2025/B