Summary & Overview
HCPCS Q4107: Graftjacket Per Square Centimeter, Surgical Graft Material
HCPCS Level II code Q4107 designates billing for Graftjacket, per square centimeter, reported as an add-on code in addition to a primary surgical procedure. This code captures the supply and application of an engineered graft material used in wound repair or surgical reconstruction and matters nationally because product-specific supply codes affect claim adjudication, coding consistency, and payment for implantable biologic materials across inpatient and outpatient procedural settings. Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find an overview of clinical and billing context for Q4107, including how the code is used alongside primary surgical procedure codes, typical sites of service where the graft is applied, and implications for coding workflows. The publication summarizes available benchmarks and payer coverage considerations, highlights common modifiers reported with procedural supply add-on codes, and outlines policy and documentation factors that influence reimbursement. Where payer-specific coverage details are not available in the input, the report notes that data are not provided. The focus is national in scope and intended for coding professionals, revenue cycle teams, and clinical staff involved in procedural supply documentation and billing.
Billing Code Overview
HCPCS Level II code Q4107 describes Graftjacket billed per square centimeter as an add-on, list separately in addition to primary procedure. This code represents billing for a biologic or engineered graft material applied during a surgical procedure and is reported in units of square centimeters.
Service Type: Surgical grafting material supply
Typical Site of Service: Hospital outpatient department or ambulatory surgical center, and other procedural settings where graft materials are applied during operative care.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient presents with a full-thickness soft tissue wound or tendon exposure of the lower extremity after traumatic injury or failed prior grafting. Surgical evaluation determines need for soft-tissue coverage using a biologic acellular dermal matrix product billed as Q4107 (Graftjacket, per square centimeter) as an add-on supply to the primary reconstructive procedure. Typical workflow: preoperative assessment in outpatient or inpatient setting by a reconstructive surgeon (plastic surgeon or orthopaedic surgeon) with imaging and wound culture as indicated; operating room procedure where primary procedure (for example, debridement, tendon repair, or flap placement) is performed followed by application of the Graftjacket to augment soft-tissue coverage; billing captures the primary CPT procedure for the surgical repair and lists Q4107 per square centimeter as an add-on supply charge. Typical site of service is an acute hospital operating room or ambulatory surgical center. Patient scenarios commonly include chronic non-healing ulcers with tendon/orthopedic exposure, traumatic soft tissue defects, or revision of prior grafts where biologic matrix is used to support tissue regeneration and provide reinforcement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unmodified service |