Summary & Overview
HCPCS Q4108: Integra Matrix, Per Square Centimeter (Add-on Supply)
HCPCS Level II code Q4108 represents the unit-based billing of an Integra dermal matrix, charged per square centimeter as an add-on to a primary surgical procedure. The code captures supply and material costs for a biologic or synthetic skin substitute used in wound reconstruction, burn care, and complex soft-tissue repair. Nationally, use of skin substitutes influences episode cost, surgical planning, and coding compliance across inpatient and outpatient operative settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for Integra matrix use, documentation and coding considerations tied to add-on supply billing, common modifiers and their typical applications, and where applicable coverage and reimbursement patterns from major payers. The publication also outlines benchmarks for per-square-centimeter supply billing and highlights policy updates or payer-specific requirements when available.
This report is intended for clinical coders, billing managers, and policy analysts seeking a national perspective on billing practice for additive dermal matrix supplies. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code Q4108 describes an Integra matrix billed per square centimeter as an add-on, listed separately in addition to the primary procedure. The service involves application of a biologic or synthetic dermal matrix (Integra) used to support dermal regeneration and wound closure.
Service type: Dermal matrix grafting / skin substitute application (add-on supply)
Typical site of service: Operative settings, including inpatient and outpatient surgical suites where the primary wound or reconstructive procedure is performed
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a large full-thickness lower-extremity wound following traumatic skin loss is taken to the operating room for debridement and definitive wound coverage. After surgical excision of nonviable tissue and preparation of the wound bed, the surgeon applies an Integra dermal regeneration template to provide a scaffold for neodermis formation prior to later split-thickness skin grafting. The service is billed as an add-on material per square centimeter using Q4108 in addition to the primary procedure for wound repair or skin grafting. Typical workflow: preoperative wound assessment and photography, operative debridement and hemostasis, measurement of graft area (documented in cm2), application and securement of the Integra matrix, placement of appropriate dressings and postoperative instructions for graft take and wound care. Typical site of service is an operating room or an ambulatory surgical center when performed under sterile conditions; application may also occur in a hospital inpatient setting for complex wounds. Common clinical indications include full-thickness burns, traumatic skin loss, chronic non-healing wounds with exposed tendon or bone, and reconstructive defects following tumor resection.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier is applicable |