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Q4013 Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster
BackQ4001Casting supplies, body cast adult, with or without head, plaster→Q4002Cast supplies, body cast adult, with or without head, fiberglass→Q4003Cast supplies, shoulder cast, adult (11 years +), plaster→Q4004Cast supplies, shoulder cast, adult (11 years +), fiberglass→Q4005Cast supplies, long arm cast, adult (11 years +), plaster→Q4006Cast supplies, long arm cast, adult (11 years +), fiberglass→Q4007Cast supplies, long arm cast, pediatric (0-10 years), plaster→Q4008Cast supplies, long arm cast, pediatric (0-10 years), fiberglass→Q4009Cast supplies, short arm cast, adult (11 years +), plaster→Q4010Cast supplies, short arm cast, adult (11 years +), fiberglass→Q4011Cast supplies, short arm cast, pediatric (0-10 years), plaster→Q4012Cast supplies, short arm cast, pediatric (0-10 years), fiberglass→Q4013Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster→Q4014Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass→Q4015Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster→Q4016Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass→Q4017Cast supplies, long arm splint, adult (11 years +), plaster→Q4018Cast supplies, long arm splint, adult (11 years +), fiberglass→Q4019Cast supplies, long arm splint, pediatric (0-10 years), plaster→Q4020Cast supplies, long arm splint, pediatric (0-10 years), fiberglass→Q4021Cast supplies, short arm splint, adult (11 years +), plaster→Q4022Cast supplies, short arm splint, adult (11 years +), fiberglass→Q4023Cast supplies, short arm splint, pediatric (0-10 years), plaster→Q4024Cast supplies, short arm splint, pediatric (0-10 years), fiberglass→Q4025Cast supplies, hip spica (one or both legs), adult (11 years +), plaster→Q4026Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass→Q4027Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster→Q4028Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass→Q4029Cast supplies, long leg cast, adult (11 years +), plaster→Q4030Cast supplies, long leg cast, adult (11 years +), fiberglass→Q4031Cast supplies, long leg cast, pediatric (0-10 years), plaster→Q4032Cast supplies, long leg cast, pediatric (0-10 years), fiberglass→Q4033Cast supplies, long leg cylinder cast, adult (11 years +), plaster→Q4034Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass→Q4035Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster→Q4036Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass→Q4037Cast supplies, short leg cast, adult (11 years +), plaster→Q4038Cast supplies, short leg cast, adult (11 years +), fiberglass→Q4039Cast supplies, short leg cast, pediatric (0-10 years), plaster→Q4040Cast supplies, short leg cast, pediatric (0-10 years), fiberglass→Q4041Cast supplies, long leg splint, adult (11 years +), plaster→Q4042Cast supplies, long leg splint, adult (11 years +), fiberglass→Q4043Cast supplies, long leg splint, pediatric (0-10 years), plaster→Q4044Cast supplies, long leg splint, pediatric (0-10 years), fiberglass→Q4045Cast supplies, short leg splint, adult (11 years +), plaster→Q4046Cast supplies, short leg splint, adult (11 years +), fiberglass→Q4047Cast supplies, short leg splint, pediatric (0-10 years), plaster→Q4048Cast supplies, short leg splint, pediatric (0-10 years), fiberglass→Q4049Finger splint, static→Q4050Cast supplies, for unlisted types and materials of casts→Q4051Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)→Q4074Iloprost, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 20 micrograms→Q4081Injection, epoetin alfa, 100 units (for esrd on dialysis)→Q4082Drug or biological, not otherwise classified, part b drug competitive acquisition program (cap)→Q4101Apligraf, per square centimeter (add-on, list separately in addition to primary procedure)→Q4102Oasis wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4103Oasis burn matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4104Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure)→Q4105Integra dermal regeneration template (drt) or integra omnigraft dermal regeneration matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4107Graftjacket, per square centimeter (add-on, list separately in addition to primary procedure)→Q4108Integra matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4110Primatrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4111Gammagraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4112Cymetra, injectable, 1 cc→Q4113Graftjacket xpress, injectable, 1 cc→Q4114Integra flowable wound matrix, injectable, 1 cc→Q4115Alloskin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4116Alloderm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4117Hyalomatrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4118Matristem micromatrix, 1 mg→Q4121Theraskin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4122Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure)→Q4123Alloskin rt, per square centimeter (add-on, list separately in addition to primary procedure)→Q4124Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4125Arthroflex, per square centimeter (add-on, list separately in addition to primary procedure)→Q4126Memoderm, dermaspan, tranzgraft or integuply, per square centimeter (add-on, list separately in addition to primary procedure)→Q4127Talymed, per square centimeter (add-on, list separately in addition to primary procedure)→Q4128Flex hd, or allopatch hd, per square centimeter (add-on, list separately in addition to primary procedure)→Q4130Strattice tm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4132Grafix core and grafixpl core, per square centimeter (add-on, list separately in addition to primary procedure)→Q4133Grafix prime, grafixpl prime, stravix and stravixpl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4134Hmatrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4135Mediskin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4136Ez-derm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4137Amnioexcel, amnioexcel plus or biodexcel, per square centimeter (add-on, list separately in addition to primary procedure)→Q4138Biodfence dryflex, per square centimeter (add-on, list separately in addition to primary procedure)→Q4139Amniomatrix or biodmatrix, injectable, 1 cc→Q4140Biodfence, per square centimeter (add-on, list separately in addition to primary procedure)→Q4141Alloskin ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4142Xcm biologic tissue matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4143Repriza, per square centimeter (add-on, list separately in addition to primary procedure)→Q4145Epifix, injectable, 1 mg→Q4146Tensix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4147Architect, architect px, or architect fx, extracellular matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4148Neox cord 1k, neox cord rt, or clarix cord 1k, per square centimeter (add-on, list separately in addition to primary procedure)→Q4149Excellagen, 0.1 cc→Q4150Allowrap ds or dry, per square centimeter (add-on, list separately in addition to primary procedure)→Q4151Amnioband or guardian, per square centimeter (add-on, list separately in addition to primary procedure)→Q4152Dermapure, per square centimeter (add-on, list separately in addition to primary procedure)→Q4153Dermavest and plurivest, per square centimeter (add-on, list separately in addition to primary procedure)→Q4154Biovance, per square centimeter (add-on, list separately in addition to primary procedure)→Q4155Neoxflo or clarixflo, 1 mg→Q4156Neox 100 or clarix 100, per square centimeter (add-on, list separately in addition to primary procedure)→Q4157Revitalon, per square centimeter (add-on, list separately in addition to primary procedure)→Q4158Kerecis omega3, per square centimeter (add-on, list separately in addition to primary procedure)→Q4159Affinity, per square centimeter (add-on, list separately in addition to primary procedure)→Q4160Nushield, per square centimeter (add-on, list separately in addition to primary procedure)→Q4161Bio-connekt wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4162Woundex flow, bioskin flow, 0.5 cc→Q4163Woundex, bioskin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4164Helicoll, per square centimeter (add-on, list separately in addition to primary procedure)→Q4165Keramatrix or kerasorb, per square centimeter (add-on, list separately in addition to primary procedure)→Q4166Cytal, per square centimeter (add-on, list separately in addition to primary procedure)→Q4167Truskin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4168Amnioband, 1 mg→Q4169Artacent wound, per square centimeter (add-on, list separately in addition to primary procedure)→Q4170Cygnus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4171Interfyl, 1 mg→Q4173Palingen or palingen xplus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4174Palingen or promatrx, 0.36 mg per 0.25 cc→Q4175Miroderm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4176Neopatch or therion, per square centimeter (add-on, list separately in addition to primary procedure)→Q4177Floweramnioflo, 0.1 cc→Q4178Floweramniopatch, per square centimeter (add-on, list separately in addition to primary procedure)→Q4179Flowerderm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4180Revita, per square centimeter (add-on, list separately in addition to primary procedure)→Q4181Amnio wound, per square centimeter (add-on, list separately in addition to primary procedure)→Q4182Transcyte, per square centimeter (add-on, list separately in addition to primary procedure)→Q4183Surgigraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4184Cellesta or cellesta duo, per square centimeter (add-on, list separately in addition to primary procedure)→Q4185Cellesta flowable amnion (25 mg per cc); per 0.5 cc→Q4186Epifix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4187Epicord, per square centimeter (add-on, list separately in addition to primary procedure)→Q4188Amnioarmor, per square centimeter (add-on, list separately in addition to primary procedure)→Q4189Artacent ac, 1 mg→Q4190Artacent ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4191Restorigin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4192Restorigin, 1 cc→Q4193Coll-e-derm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4194Novachor, per square centimeter (add-on, list separately in addition to primary procedure)→Q4195Puraply, per square centimeter (add-on, list separately in addition to primary procedure)→Q4196Puraply am, per square centimeter (add-on, list separately in addition to primary procedure)→Q4197Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure)→Q4198Genesis amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4199Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4200Skin te, per square centimeter (add-on, list separately in addition to primary procedure)→Q4201Matrion, per square centimeter (add-on, list separately in addition to primary procedure)→Q4202Keroxx (2.5g/cc), 1cc→Q4203Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure)→Q4204Xwrap, per square centimeter (add-on, list separately in addition to primary procedure)→Q4205Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)→Q4206Fluid flow or fluid gf, 1 cc→Q4207Carbon life, per square centimeter (add-on, list separately in addition to primary procedure)→Q4208Novafix, per square cenitmeter (add-on, list separately in addition to primary procedure)→Q4209Surgraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4211Amnion bio or axobiomembrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4212Allogen, per cc→Q4213Ascent, 0.5 mg→Q4214Cellesta cord, per square centimeter (add-on, list separately in addition to primary procedure)→Q4215Axolotl ambient or axolotl cryo, 0.1 mg→Q4216Artacent cord, per square centimeter (add-on, list separately in addition to primary procedure)→Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4218Surgicord, per square centimeter (add-on, list separately in addition to primary procedure)→Q4219Surgigraft-dual, per square centimeter (add-on, list separately in addition to primary procedure)→Q4220Bellacell hd or surederm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4221Amniowrap2, per square centimeter (add-on, list separately in addition to primary procedure)→Q4222Progenamatrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4223Dermabind sl optic, per square centimeter (add-on, list separately in addition to primary procedure)→Q4224Human health factor 10 amniotic patch (hhf10-p), per square centimeter (add-on, list separately in addition to primary procedure)→Q4225Amniobind or dermabind tl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4226Myown skin, includes harvesting and preparation procedures, per square centimeter→Q4227Amniocore, per square centimeter (add-on, list separately in addition to primary procedure)→Q4229Cogenex amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4230Cogenex flowable amnion, per 0.5 cc→Q4232Corplex, per square centimeter (add-on, list separately in addition to primary procedure)→Q4233Surfactor or nudyn, per 0.5 cc→Q4234Xcellerate, per square centimeter (add-on, list separately in addition to primary procedure)→Q4235Amniorepair or altiply, per square centimeter (add-on, list separately in addition to primary procedure)→Q4236Carepatch, per square centimeter (add-on, list separately in addition to primary procedure)→Q4237Cryo-cord, per square centimeter (add-on, list separately in addition to primary procedure)→Q4238Derm-maxx, per square centimeter (add-on, list separately in addition to primary procedure)→Q4239Amnio-maxx or amnio-maxx lite, per square centimeter (add-on, list separately in addition to primary procedure)→Q4240Corecyte, for topical use only, per 0.5 cc→Q4241Polycyte, for topical use only, per 0.5 cc→Q4242Amniocyte plus, per 0.5 cc→Q4243Amchomatrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4245Amniotext, per cc→Q4246Coretext or protext, per cc→Q4247Amniotext patch, per square centimeter (add-on, list separately in addition to primary procedure)→Q4248Dermacyte amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4249Amniply, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure)→Q4250Amnioamp-mp, per square centimeter (add-on, list separately in addition to primary procedure)→Q4251Vim, per square centimeter (add-on, list separately in addition to primary procedure)→Q4252Vendaje, per square centimeter (add-on, list separately in addition to primary procedure)→Q4253Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4254Novafix dl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4255Reguard, for topical use only, per square centimeter (add-on, list separately in addition to primary procedure)→Q4256Mlg-complete, per square centimeter (add-on, list separately in addition to primary procedure)→Q4257Relese, per square centimeter (add-on, list separately in addition to primary procedure)→Q4258Enverse, per square centimeter (add-on, list separately in addition to primary procedure)→Q4259Celera dual layer or celera dual membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4260Signature apatch, per square centimeter (add-on, list separately in addition to primary procedure)→Q4261Tag, per square centimeter (add-on, list separately in addition to primary procedure)→Q4262Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4263Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4264Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4265Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4266Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4267Neostim dl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4268Surgraft ft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4269Surgraft xt, per square centimeter (add-on, list separately in addition to primary procedure)→Q4270Complete sl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4271Complete ft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4272Esano a, per square centimeter (add-on, list separately in addition to primary procedure)→Q4273Esano aaa, per square centimeter (add-on, list separately in addition to primary procedure)→Q4274Esano ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4275Esano aca, per square centimeter (add-on, list separately in addition to primary procedure)→Q4276Orion, per square centimeter (add-on, list separately in addition to primary procedure)→Q4278Epieffect, per square centimeter (add-on, list separately in addition to primary procedure)→Q4279Vendaje ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4280Xcell amnio matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4281Barrera sl or barrera dl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4282Cygnus dual, per square centimeter (add-on, list separately in addition to primary procedure)→Q4283Biovance tri-layer or biovance 3l, per square centimeter (add-on, list separately in addition to primary procedure)→Q4284Dermabind sl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4285Nudyn dl or nudyn dl mesh, per square centimeter (add-on, list separately in addition to primary procedure)→Q4286Nudyn sl or nudyn slw, per square centimeter (add-on, list separately in addition to primary procedure)→Q4287Dermabind dl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4288Dermabind ch, per square centimeter (add-on, list separately in addition to primary procedure)→Q4289Revoshield + amniotic barrier, per square centimeter (add-on, list separately in addition to primary procedure)→Q4290Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)→Q4291Lamellas xt, per square centimeter (add-on, list separately in addition to primary procedure)→Q4292Lamellas, per square centimeter (add-on, list separately in addition to primary procedure)→Q4293Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4294Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)→Q4295Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)→Q4296Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4297Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4298Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)→Q4299Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)→Q4300Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4301Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4302Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)→Q4303Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)→Q4304Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4305American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)→Q4306American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4307American amnion, per square centimeter (add-on, list separately in addition to primary procedure)→Q4308Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)→Q4309Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4310Procenta, per 100 mg→Q4311Acesso, per square centimeter (add-on, list separately in addition to primary procedure)→Q4312Acesso ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4313Dermabind fm, per square centimeter (add-on, list separately in addition to primary procedure)→Q4314Reeva ft, per square cenitmeter (add-on, list separately in addition to primary procedure)→Q4315Regenelink amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4316Amchoplast, per square centimeter (add-on, list separately in addition to primary procedure)→Q4317Vitograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4318E-graft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4319Sanograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4320Pellograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4321Renograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4322Caregraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4323Alloply, per square centimeter (add-on, list separately in addition to primary procedure)→Q4324Amniotx, per square centimeter (add-on, list separately in addition to primary procedure)→Q4325Acapatch, per square centimeter (add-on, list separately in addition to primary procedure)→Q4326Woundplus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4327Duoamnion, per square centimeter (add-on, list separately in addition to primary procedure)→Q4328Most, per square centimeter (add-on, list separately in addition to primary procedure)→Q4329Singlay, per square centimeter (add-on, list separately in addition to primary procedure)→Q4330Total, per square centimeter (add-on, list separately in addition to primary procedure)→Q4331Axolotl graft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4332Axolotl dualgraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4333Ardeograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4334Amnioplast 1, per square centimeter (add-on, list separately in addition to primary procedure)→Q4335Amnioplast 2, per square centimeter (add-on, list separately in addition to primary procedure)→Q4336Artacent c, per square centimeter (add-on, list separately in addition to primary procedure)→Q4337Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure)→Q4338Artacent velos, per square centimeter (add-on, list separately in addition to primary procedure)→Q4339Artacent vericlen, per square centimeter (add-on, list separately in addition to primary procedure)→Q4340Simpligraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4341Simplimax, per square centimeter (add-on, list separately in addition to primary procedure)→Q4342Theramend, per square centimeter (add-on, list separately in addition to primary procedure)→Q4343Dermacyte ac matrix amniotic membrane allograft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4344Tri-membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)→Q4345Matrix hd allograft dermis, per square centimeter (add-on, list separately in addition to primary procedure)→Q4346Shelter dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4347Rampart dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4348Sentry sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4349Mantle dl matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4350Palisade dm matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4351Enclose tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4352Overlay sl matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4353Xceed tl matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4354Palingen dual-layer membrane and dual-layer palingen x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4355Abiomend xplus membrane and abiomend xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4356Abiomend membrane and abiomend hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4357Xwrap plus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4358Xwrap dual, per square centimeter (add-on, list separately in addition to primary procedure)→Q4359Choriply, per square centimeter (add-on, list separately in addition to primary procedure)→Q4360Amchoplast fd, per square centimeter (add-on, list separately in addition to primary procedure)→Q4361Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)→Q4362Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)→Q4363Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4364Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4365Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4366Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4367Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4368Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)→Q4369Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)→Q4370Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)→Q4371Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)→Q4372Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)→Q4373Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)→Q4375Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4376Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)→Q4377Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4378Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4379Amniodefend ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4380Advograft one, per square centimeter (add-on, list separately in addition to primary procedure)→Q4382Advograft dual, per square centimeter (add-on, list separately in addition to primary procedure)→Q4383Axolotl graft ultra, per square centimeter (add-on, list separately in addition to primary procedure)→Q4384Axolotl dualgraft ultra, per square centimeter (add-on, list separately in addition to primary procedure)→Q4385Apollo ft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4386Acesso trifaca, per square centimeter (add-on, list separately in addition to primary procedure)→Q4387Neothelium ft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4388Neothelium 4l, per square centimeter (add-on, list separately in addition to primary procedure)→Q4389Neothelium 4l+, per square centimeter (add-on, list separately in addition to primary procedure)→Q4390Ascendion, per square centimeter (add-on, list separately in addition to primary procedure)→Q4391Amnioplast double, per square centimeter (add-on, list separately in addition to primary procedure)→Q4392Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)→Q4393Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4394Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)→Q4395Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4396Natalin, per square centimeter (add-on, list separately in addition to primary procedure)→Q4397Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)→Q4398Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4399Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)→Q4400Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4401Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4402Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)→Q4403Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4404Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4405Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4406Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)→Q4407Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)→Q4408Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)→Q4409Amniomatrixf3x, per square centimeter (add-on, list separately in addition to primary procedure)→Q4410Amchomatrixdl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4411Amniomatrixf4x, per square centimeter (add-on, list separately in addition to primary procedure)→Q4412Choriofix, per square centimeter (add-on, list separately in addition to primary procedure)→Q4413Cygnus solo, per square centimeter (add-on, list separately in addition to primary procedure)→Q4414Simplichor, per square centimeter (add-on, list separately in addition to primary procedure)→Q4415Alexiguard sl-t, per square centimeter (add-on, list separately in addition to primary procedure)→Q4416Alexiguard tl-t, per square centimeter (add-on, list separately in addition to primary procedure)→Q4417Alexiguard dl-t, per square centimeter (add-on, list separately in addition to primary procedure)→Q4418Biolab membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)→Q4419Biolab membrane wrap lite flow, per square centimeter (add-on, list separately in addition to primary procedure)→Q4420Nuform, per square centimeter (add-on, list separately in addition to primary procedure)→Q4421Biolab membrane wrap solo, per square centimeter (add-on, list separately in addition to primary procedure)→Q4422A/c wrap, per square centimeter (add-on, list separately in addition to primary procedure)→Q4423Biolab tri-membrane wrap flow, per square centimeter (add-on, list separately in addition to primary procedure)→Q4424Revive ft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4425Revive tl, per square centimeter (add-on, list separately in addition to primary procedure)→Q4426Dermabind tl + or dermabind tl x, per square centimeter (add-on, list separately in addition to primary procedure)→Q4427Dermabind dl n or dermabind dl + or dermabind dl x, per square centimeter (add-on, list separately in addition to primary procedure)→Q4428Dermabind sl n or dermabind sl + or dermabind sl x, per square centimeter (add-on, list separately in addition to primary procedure)→Q4429Dermabind ch n or dermabind ch x, per square centimeter (add-on, list separately in addition to primary procedure)→Q4431Pma skin substitute product, not otherwise specified (list in addition to primary procedure)→Q4432510(k) skin substitute product, not otherwise specified (list in addition to primary procedure)→Q4433361 hct/p skin substitute product, not otherwise specified (list in addition to primary procedure)→Q4435Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4436Renati ac membrane, per square centimeter (add-on, list separately in addition to primary procedure)→Q4437Revival ac, per square centimeter (add-on, list separately in addition to primary procedure)→Q4438Pretect, per square centimeter (add-on, list separately in addition to primary procedure)→Q4439Instagraft, per square centimeter (add-on, list separately in addition to primary procedure)→Q4440Curamatrix, per square centimeter (add-on, list separately in addition to primary procedure)→
Procedure codeCODABLE
Q4013
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster
- Part
- HCPCS Level II
- Q
- Temporary Codes
- Q4
- Q4001–Q4440
Source
CMS — ICD-10-PCS FY2026, HCPCS Level II october 2026, Procedure Codes 2026.