Summary & Overview
HCPCS Q4147: Extracellular Matrix Graft, Per Square Centimeter
HCPCS Level II code Q4147 denotes an extracellular matrix product billed per square centimeter as an add-on to a primary surgical procedure. These biologic graft materials are used to support tissue repair, reconstruction, or wound management during operative care, and billing as an add-on reflects that the product is supplied in addition to the main procedure. Nationally, add-on supply codes like Q4147 matter because they affect bundled payment calculations, clinical documentation requirements, and hospital or ambulatory surgical center supply cost accounting.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical role and billing context, typical sites of service where the product is used, and expected reporting conventions. The publication also summarizes benchmarking approaches, payer coverage considerations, and relevant documentation practices tied to add-on biomaterial products.
This briefing is written for a national audience of clinicians, coding and billing staff, and policy analysts seeking a clear summary of HCPCS Level II code Q4147 and its implications for surgical supply billing and clinical documentation. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4147 describes architect, architect px, or architect fx, extracellular matrix, per square centimeter (add-on, list separately in addition to primary procedure). This code represents an extracellular matrix graft product used as an add-on material applied per square centimeter to support tissue repair or reconstruction during a surgical procedure.
Service Type
- Service type: Surgical adjunct or biomaterial graft application
Typical Site of Service
- Typical site of service: Hospital operating room, ambulatory surgical center, or other outpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a chronic, non-healing soft-tissue wound such as a diabetic foot ulcer, venous stasis ulcer, or surgically debrided traumatic wound that requires biologic extracellular matrix placement to promote tissue regeneration. The patient presents to an outpatient wound care clinic or ambulatory surgery center after failure of standard local wound care and offloading. The wound care team (wound care physician or surgeon, nurse, and wound care specialist) assesses the wound, documents size in square centimeters, performs necessary sharp or surgical debridement, and determines that an extracellular matrix product (architect, architect px, or architect fx) is indicated as an adjunctive graft material.
During the visit or procedure encounter the provider measures the wound, records indications, and applies the extracellular matrix to the wound bed in a sterile field. The procedure is billed as an add-on per square centimeter using Q4147 in addition to the primary procedure(s) such as debridement or closure. Typical sites of service include outpatient wound clinics, physician offices with procedural capability, ambulatory surgery centers, and inpatient hospital settings when part of a larger operative episode. Post-application monitoring and standard wound care follow-up visits occur in clinic according to the wound care plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |