Summary & Overview
HCPCS Q4130: Strattice™ Per Square Centimeter, Surgical Mesh
HCPCS Level II code Q4130 denotes Strattice™ billed per square centimeter as an add-on supply to a primary surgical procedure. The code specifies the unit of measure for a biological surgical mesh product used in reconstructive and soft-tissue repair procedures and matters nationally because device and implant supply billing affects surgical episode costs and payer coverage determinations across hospitals and ambulatory surgical centers. Payers commonly involved in coverage and reimbursement for implantable biologic products include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical and billing context for this add-on supply code, including where the product is typically used (operating rooms and ambulatory surgery centers), how the code functions as an adjunct to primary procedure coding, and which major payers are relevant for policy and coverage considerations. The publication provides benchmarks and policy-focused summaries where available, clarifies common billing practices, and highlights areas where payers may apply separate coverage rules or prior authorization for biologic mesh products. Data not available in the input will be clearly noted in relevant sections.
Billing Code Overview
HCPCS Level II code Q4130 represents Strattice™ charged per square centimeter and is designated as an add-on, list separately in addition to primary procedure item. The code describes the billing unit for a biologic or surgical mesh product supplied during surgical procedures.
Service Type: Surgical implantable biologic/surgical mesh supply
Typical Site of Service: Hospital operating room, ambulatory surgery center, or inpatient surgical setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents with a recurrent ventral hernia after prior abdominal surgery and has a large fascial defect with attenuated tissue unsuitable for primary closure. During an elective open ventral hernia repair in the operating room, the surgical team performs fascial repair and implants a biologic acellular dermal matrix, Strattice, to reinforce the repair and reduce recurrence risk. The procedure is billed as an add-on material charge per square centimeter using Q4130 in addition to the primary hernia repair CPT code. Typical perioperative workflow includes preoperative evaluation, intraoperative measurement of the graft surface area to document square centimeters used, placement of the biologic mesh underlay or onlay with appropriate fixation, and postoperative monitoring for wound healing given higher risk of surgical site occurrence in complex or contaminated fields.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for the primary procedure involving Q4130 material use and documentation supports increased effort. |
23 | Unusual anesthesia | Use when general anesthesia is not planned but a procedure requires the use of an anesthesia method that is unusual for the procedure code paired with .