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Q4 2026 starts Oct 1, 2026. Preview changes

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HCPCS Q4112

Contractor-priced

Q4112 · PFS Q3 2026

No national PFS rate in Q3 2026

Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

Check for a published amount in your locality.

Not at a published national rate. HCPCS Q4112 carries status C (carrier-priced) in the Q3 2026 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Inspect PFS status evidence
Code
Q4112
Release
Q3 2026, revision 1
Result
Contractor-priced

Citations

  • Establishes the PFS status (C) and the resulting pathway for this code: contractor-priced.

    Physician relative value file (PPRRVU)

    Q3 2026 · revision 1

    Latest revision of this release

    Release period: July 1 – September 30, 2026

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    Record details PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 18,118)
    hcpcs (col 1)
    Q4112
    modifier (col 2)
    blank
    status_code (col 4)
    C

    SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

    Original source file

Compact facts

Why is there no national PFS amount for Q4112?

Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Carrier-priced: no national payment amount.

About this code

Cymetra injectable

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

Other payment indicators (8)

Facility/non-facility: Not determined, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Does not apply, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.

Reconciling a contractor-priced payment for Q4112 Copy link

There is no national allowed amount for Q4112, so every reconciliation of this line runs against the MAC fee schedule that was in force for the date of service rather than against a national baseline.

What to reconcile

  • Compare the paid amount against the MAC fee schedule in force for the date of service; there is no national allowed amount here to reconcile against.
  • Only a technical-component amount is published for this code, so a professional charge billed on it has no fee-schedule amount behind it.
  • Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.

Nearby payment lines

National Q3 2026 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

Code Why compare Office Facility
Q4111 Priced as active rather than carrier-priced $127.26 $127.26
Q4116 Priced as active rather than carrier-priced $127.26 $127.26
Q4110 Priced as active rather than carrier-priced $127.26 $127.26

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04).

Payment rules

Global period: what Q4112's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Billing policy Copy link

What Q4112's billing-policy indicators mean. These show for every code, priced or not: a restriction like "bilateral not allowed" still matters on a carrier-priced code.

Policy Value What it means
Professional/technical split 3 Technical component only. Only a technical component exists for this code—there is no corresponding professional-component amount to bill.

Can you bill it with another code? Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and Q4112.

See every current NCCI pair for Q4112 →

Common payment questions Copy link

Why would a Medicare claim for Q4112 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is C (carrier-priced)—Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators
  • Only a technical component exists for Q4112—there is no professional-component amount to bill. See billing policy

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.

History
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.

Usage & related

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Source & method

Show sources

Contractor amounts come from the MAC-published schedules and effective dates identified above. The PFS file establishes contractor pricing. Releases are immutable: historical evidence remains tied to the specified release. CMS owns the code description shown for HCPCS Level II codes. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

HCPCS Q4112 National PFS baseline: No national PFS rate (Q3 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/hcpcs/Q4112/2026/C