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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q4131-epifix-epicord-biologic-wound-graft-per-cm2
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    HCPCS Q4131: Epifix or Epicord, Per Square Centimeter

    HCPCS Level II code Q4131 describes billing for Epifix or Epicord graft material charged per square centimeter, a human placental membrane product used as a biologic wound matrix for tissue repair; service type: biologic graft placement / wound care supply; typical site of service: outpatient wound care clinics, physician offices, and outpatient surgical centers.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a chronic, non-healing lower extremity wound (such as a diabetic foot ulcer or venous stasis ulcer) that has failed standard wound care including debridement, offloading, infection control, and moist wound dressings. The clinician evaluates the wound at an outpatient wound care clinic or hospital-based clinic. After assessment including wound measurements, infection status, vascular status, and documentation of prior conservative therapies, the provider determines that an advanced biologic graft is indicated.

    The clinical workflow includes wound bed preparation (sharp or surgical debridement) and hemostasis, application of the dehydrated human amnion/chorion membrane product billed as Q4131 (Epifix or Epicord) sized and priced per square centimeter, securing the graft to the wound bed, and covering with an appropriate dressing. Post-procedure instructions address offloading, wound care follow-up, and signs of infection. Typical sites of service are outpatient wound care centers, hospital outpatient departments, ambulatory surgery centers (if debridement or more complex procedures are performed), and occasionally inpatient settings for patients with comorbid conditions requiring admission.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11042Debridement; skin, subcutaneous tissue and muscle (e.g., for complicated wounds)Often performed immediately prior to application of Q4131 to prepare the wound bed for graft placement.
    97602Application of a topical wound care product (must include instruction and dressing)Used for non-selective debridement or for application of certain topical products and dressing changes in the wound care workflow; may be billed on subsequent visits.
    97597Debridement (selective) by sharp/shaving (first 20 sq cm or less)Used for selective debridement of wound margins prior to biologic graft placement.
    15271Application of skin substitute graft to trunk, arms, legs; first 100 sq cm or less (non-breast)Alternative skin substitute application code when an allograft or skin substitute is applied; may be used in certain payer policies alongside HCPCS product billing documentation.
    11043Debridement; includes skin, subcutaneous tissue, muscle and bone when indicatedUsed for deeper debridement in complex wounds before placement of biologic grafts.

    Related Modifiers

    6 rows

    ModifierDescriptionWhen to Use
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    174400000XSpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond…
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208D00000XGeneral Practice PhysicianA physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
    207R00000XInternal Medicine PhysicianA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults…
    2080P0203XPediatric Critical Care Medicine PhysicianA pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the criti…
    320700000XPhysical Disabilities Residential Treatment FacilityA residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and…
    3336L0003XLong Term Care PharmacyA pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermed…

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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