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HCPCS Q4142

Xcm biologic tiss matrix 1cm

Excluded from PFS — out of payment scope by statute, regulation, non-coverage, or reporting-only status.

HCPCS Level II

No national payment amount in Q2 2019

Status E is not separately payable under the PFS.

National amount today · Q3 2026

$127.26

The Q2 2019 release carries no national amount for Q4142, but the current Q3 2026 release prices it: $127.26 in an office (non-facility) and $127.26 in a facility. That is today’s figure, not Q2 2019’s — national, before geographic adjustment and before the ~2% sequestration cut.

Reading an old claim? Keep this page for Q2 2019 and open the current Q4142 page for today’s.

Did Medicare pay separately for HCPCS Q4142 in Q2 2019? Copy link

Not at a published national rate. HCPCS Q4142 carries status E (excluded) in the Q2 2019 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.

Source: Physician relative value file (Q2 2019) · effective April 2019 · materially updated Aug 4, 2026 · compact facts

Why isn't there a national PFS amount?

  • Status E (Excluded): A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead.
  • Status E is not separately payable under the PFS.

CMS evidence · 2 sources

Open evidence
Physician relative value file (Q2 2019) · rvu19b.zip (PPRRVU19_APR.csv row 3,845)

See full source & method below

Common questions Copy link

Why is there no payment amount for Q4142?

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 Q4142 be denied or paid less?

These come from CMS indicators 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.

Payment rules

Applicable payment rules Copy link

Only the rules that can matter for Q4142, each linking to its detail on this page.

Facility/non-facility Not modeled Professional/technical component Does not apply 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 Not modeled MUE behavior Not modeled Other fee-schedule routing Does not apply Contractor pricing Does not apply

Global period: what Q4142's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Modifiers that report work outside Q4142's global period
Modifier Reports
-25 A significant, separately identifiable E/M on the same day as the procedure, beyond its usual pre- and post-operative care.

A modifier reports what happened; it does not by itself make a service payable. Documentation has to support it.

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 Q4142.

See every current NCCI pair for Q4142 →

History

Rate history by release Copy link

National non-facility amount for Q4142 across quarterly releases. Unchanged since Q1 2026 · high $127.26 in Q1 2026

$128 $128 $127 $127 $126 Q1 2026 · $127.26 Q2 2026 · $127.26 (0.0%) Q3 2026 · $127.26 (0.0%) Q2 2014 Q4 2016 Q2 2019 Q3 2021 Q1 2024 Q3 2026
Non-facility Facility
Release Status Non-facility Facility
Q3 2026 Jul 1, 2026 – present A $127.26 (0.0% no change ) $127.26 (0.0% no change )
Q1 2026 Jan 1, 2026 – Mar 31, 2026 A $127.26 $127.26

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Source & method

Show sources

This is computed from CMS's Medicare Physician Fee Schedule Q2 2019 release (schedule pfs, effective April 2019). 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. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q2 2019) · rvu19b.zip (PPRRVU19_APR.csv row 3,845)

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 2019 figures, even after a newer release lands.

HCPCS Q4142 Medicare Physician Fee Schedule rate (Q2 2019). Localis. https://localishealth.com/hcpcs/Q4142/2019/B