HCPCS Q4276: Orion Supply, Per Square Centimeter (Add-On)

HCPCS Level II code Q4276 designates the supply "Orion" billed per square centimeter as an add-on item reported in addition to a primary procedure. This code matters nationally because it standardizes reporting for area-based materials or implants, enabling clearer claims processing and more consistent aggregation of utilization and cost for procedures that require adjunctive materials.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, typical clinical context and site of service, and the scope of payers considered. The publication outlines benchmarks and payment considerations commonly reviewed by payers, highlights coding and billing implications for add-on, per-area supplies, and summarizes common modifiers used with this code.

The report covers clinical context for use alongside primary surgical or procedural services, payer coverage patterns, and operational notes relevant to billing teams and compliance officers. Where specific input data is missing, the text notes that information is not available. This national-focused summary is intended for revenue cycle professionals, clinicians involved in procedural supply selection, and policy analysts tracking HCPCS Level II material reporting.

Billing Code Overview

HCPCS Level II code Q4276 describes Orion, per square centimeter (add-on, list separately in addition to primary procedure). This code is used to report the supply or material identified as "Orion" billed on a per-square-centimeter basis when provided in conjunction with a primary procedure. The service type is the provision of a billed medical material or implant component measured by area, and the typical site of service is the clinical setting where the primary procedure occurs, such as an operating room or procedure suite where area-based grafts, implants, or applied materials are used.

Data not available in the input.

Clinical Context

A patient with a localized skin defect or wound requires application of an advanced wound coverage matrix product billed per square centimeter. Typical scenario: a 58-year-old patient with a chronic non-healing lower extremity ulcer undergoes debridement and preparation of the wound bed in the outpatient surgical clinic or ambulatory surgery center. After achieving hemostasis and an adequate granulating bed, the clinician applies an acellular dermal matrix product (Orion) sized to the wound surface; the product is billed as an add-on by square centimeter using code Q4276 in addition to the primary procedure for wound debridement or graft placement. Typical sites of service include hospital outpatient departments, ambulatory surgery centers, and office-based surgical suites. The workflow includes wound assessment and measurement, surgical or sharp debridement (if indicated), product sizing and placement, securement with sutures or dressings, and post-procedure wound care instructions with scheduled follow-up for dressing changes and assessment of graft incorporation.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or technical difficulty for the primary procedure and application of `Q4276` substantially exceeds typical; document rationale.

Taxonomy Code	Specialty	Notes
`208100000X`	General Surgery	General surgeons frequently perform debridement and placement of wound matrices.
`207Q00000X`	Plastic Surgery	Plastic surgeons manage complex soft tissue reconstruction and dermal matrix application.
`207L00000X`	Podiatry	Podiatrists commonly treat lower-extremity ulcers and apply advanced wound products.
`363A00000X`	Wound Care Specialist	Clinicians specializing in wound management often coordinate product use and follow-up.
`207P00000X`	Dermatology	Dermatologists may apply dermal substitutes for complex skin defects.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L97.421`	Non-pressure chronic ulcer of left heel and midfoot with nonpurulent chronic ulcer	Chronic lower-extremity ulcers are common indications for advanced wound matrix application.
`L97.022`	Non-pressure chronic ulcer of left calf with fat layer exposed	Deep non-healing ulcers requiring soft tissue coverage and dermal matrices.
`I70.249`	Atherosclerosis of native arteries of the extremities with unspecified ulceration, unilateral	Peripheral arterial disease–related ulcers often need adjunctive products after revascularization and debridement.
`E11.621`	Type 2 diabetes mellitus with foot ulcer	Diabetic foot ulcers are a frequent clinical context for use of dermal substitutes billed per square centimeter.
`L89.303`	Pressure ulcer of sacral region, stage 3	Pressure ulcers with tissue loss may require advanced biologic or dermal matrix products for closure.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue; first 20 sq cm or less	Commonly performed immediately before application of `Q4276` to prepare wound bed.
`15271`	Application of autologous skin substitute graft, first 100 sq cm or less	May be performed in workflows where grafting is combined with or followed by placement of a dermal matrix product.
`15777`	Dermal substitute graft, first 20 sq cm or less	Related reconstructive procedure that may be coded alongside product application when clinically indicated.
`97607`	Negative pressure wound therapy (NPWT) application, wound care management	Often used after matrix placement to promote adherence and healing.
`11043`	Debridement, muscle and/or fascia; first 20 sq cm or less	Performed for deeper wound bed preparation prior to matrix application.

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Summary & Overview