Q4337 Artacent Trident HCPCS: Reimbursement Benchmarks | OpenPayer

Summary & Overview

HCPCS Q4337: Artacent Trident Add-on Device, Per Square Centimeter

HCPCS Level II code Q4337 identifies Artacent trident billed per square centimeter as an add-on item to a primary procedure. As an add-on device/supply code, it is billed in addition to the main procedural code and matters nationally because it affects procedure-level costing, reimbursement aggregation, and reporting for services that use this product. Facilities and clinicians must list it separately to ensure appropriate payment and tracking of device utilization.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of how this code is used clinically and in billing, national implications for reimbursement and procedure costing, and the types of benchmarks and policy items typically reviewed when add-on device codes are analyzed.

The publication provides: (1) benchmarks and comparative payment context where available; (2) policy and coverage considerations relevant to add-on device codes; and (3) clinical context describing the service type and typical sites of service. Where input data is not provided, the text notes that specific data elements are not available in the input. This summary is intended for national audiences tracking device add-on billing and payment considerations.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareQ4337HCPCS Level IIdevice add-onsurgical supplyprocedure billingreimbursementbilling complianceoperating room

Billing Code Overview

HCPCS Level II code Q4337 describes Artacent trident, per square centimeter (add-on, list separately in addition to primary procedure). The code represents billing for a topical or implantable product identified as Artacent trident, priced or billed by the square centimeter as an add-on supply or device.

Service Type: Device/supply add-on

Typical Site of Service: Operative or procedural settings where the primary procedure is performed (e.g., surgical suite, ambulatory surgery center, hospital operating room)

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A patient with a full-thickness or deep partial-thickness skin defect following trauma or surgical excision (for example, excision of a large dermatologic lesion or debridement of an infected wound) requires placement of an advanced dermal matrix product. The clinical team prepares the wound bed in the operating room or procedure suite, obtains hemostasis, and measures the graft area in square centimeters. The additive product Q4337 (Artacent trident, per square centimeter) is applied in addition to the primary reconstructive procedure (such as a skin graft or flap) to reinforce dermal regeneration, support neovascularization, or improve contour and healing in complex or high-risk wounds. Typical workflow: preoperative assessment and documentation of wound size and indication; primary procedure (e.g., skin grafting) performed; application and fixation of the dermal matrix measured and billed per cm2 using Q4337; postoperative wound care instructions and follow-up visits documented. Typical site of service is an outpatient surgery center or hospital operating room; minor applications may occur in an ambulatory clinic procedure room under local anesthesia. A representative patient scenario: a 58-year-old diabetic patient undergoes excision of a non-melanoma skin cancer on the lower leg resulting in a 45 cm2 defect. After debridement and placement of a split-thickness skin graft, the surgeon applies an adjunctive dermal matrix product and documents the exact number of square centimeters for billing with Q4337 as an add-on code to the primary reconstructive CPT code.

Coding Specifications

Modifier	Description	When to Use

HCPCS Level II Q4416: Alexiguard tl-t, Topical per Square Centimeter

HCPCS-Q4333-ARDEOGRAFT-PER-SQ-CM-GRAFT-PRODUCT-ADD-ON

HCPCS Level II Q4333: Ardeograft Per Square Centimeter, Add-On

HCPCS-Q4021-SHORT-ARM-PLASTER-SPLINT-ADULT

HCPCS Q4021: Short Arm Plaster Splint, Adult (11+)

HCPCS-Q0479-VAD-POWER-MODULE-REPLACEMENT

HCPCS Q0479: VAD Power Module Replacement

HCPCS-Q2037-INFLUENZA-VACCINE-FLUVIRIN-IMS

HCPCS Q2037: Influenza Vaccine (Fluvirin) IM, Age ≥3

HCPCS-Q0487-VENTRICULAR-ASSIST-DEVICE-REPLACEMENT-LEADS

HCPCS Q0487: Replacement Leads for Ventricular Assist Devices

HCPCS-Q4235-AMNIOREPAIR-AMNIOTIC-GRAFT-PER-SQ-CM

HCPCS Q4235: Amniorepair (Altiply) per Square Centimeter

HCPCS-Q4118-MATRISTEM-MICROMATRIX-1MG

HCPCS Q4118: Matristem micromatrix, 1 mg

HCPCS-Q4371-NEOGUARD-PER-SQ-CM-ADD-ON

HCPCS Q4371: Neoguard per Square Centimeter (Add-on Supply)

HCPCS-Q4370-AEROGUARD-SKIN-PROTECTION-PER-SQ-CM

HCPCS Level II Q4370: Aeroguard per Square Centimeter

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Taxonomy Code	Specialty	Notes
`207P00000X`	Dermatology	Common specialty performing skin excisions and adjunctive dermal matrix applications.
`208600000X`	Plastic Surgery	Frequently performs reconstructive procedures with dermal matrices and skin grafting.
`208800000X`	General Surgery	Performs soft tissue excision and reconstruction in hospital settings.
`163W00000X`	Wound Care Specialist	Applies dermal adjuncts in complex wound management and outpatient settings.
`207L00000X`	Otolaryngology (ENT)	May perform facial skin reconstruction and adjunctive dermal matrix placement.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S81.811A`	Laceration without foreign body of right lower leg, initial encounter	Traumatic skin loss requiring excision/debridement and adjunctive dermal matrix application billed with `Q4337`.
`L98.4`	Nonhealing surgical wound	Chronic or nonhealing wounds where a dermal matrix adjunct may be used to promote healing.
`L08.9`	Local infection of skin and subcutaneous tissue, unspecified	Infected wounds after debridement may require reconstructive procedures with adjunctive matrix products.
`C44.512`	Basal cell carcinoma of skin of right lower leg, mid [example cancer code]	After oncologic excision creating a defect, adjunct dermal matrices support reconstruction and are billed per cm2 with `Q4337`.
`E11.621`	Type 2 diabetes mellitus with foot ulcer	Diabetic ulcers often require debridement and reconstruction with dermal adjuncts to improve healing outcomes.
`T81.4XXA`	Infection following a procedure, initial encounter	Postoperative wound complications that may prompt use of advanced wound products during revision procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`15271`	Placement of a biologic graft (e.g., xenograft) in a wound 35 sq cm to 55 sq cm; first graft	May represent a primary grafting procedure performed before or with adjunctive matrix billed as `Q4337` per cm2.
`15274`	Placement of a biologic graft in a wound greater than 250 sq cm; each additional 100 sq cm	Used for large surface area grafting; `Q4337` is billed additionally per square centimeter for the dermal matrix product.
`15732`	Dermabrasion; trunk, arms, legs, hands, feet (per 10 sq cm)	May be performed in conjunction with wound bed preparation prior to grafting and adjunctive matrix application.
`15100`	Split-thickness autograft, first 100 sq cm or less, or 2 separate sites, same donor site	Common primary procedure (skin autograft) to which `Q4337` is an add-on product to support dermal regeneration.
`15200`	Full-thickness skin graft, trunk, arms, legs; first 100 sq cm or less	Primary reconstructive option; `Q4337` billed in addition when an adjunct dermal matrix is used.
`11042`	Debridement; skin and subcutaneous tissue	Often performed prior to placement of a graft and adjunctive dermal matrix; prepares wound bed for optimal incorporation.

`00`	No modifier used	Default when no special circumstances apply to the service containing `Q4337`.
`22`	Increased procedural services	Use when additional work or complexity for the primary procedure and application of the dermal matrix is documented and justified.
`23`	Unusual anesthesia	Use when the procedure required general or other unusual anesthesia that is not normally required for the primary service.
`52`	Reduced services	Use when the full intended dermal matrix application was partially performed or reduced and documentation supports reduced service.
`53`	Discontinued procedure	Use when the procedure (including application of the adjunct product) was started but terminated for patient safety before completion.
`54`	Surgical care only	Use when reporting only the surgical portion; anesthesia or global care billed separately.
`55`	Postoperative management only	Use when only postoperative care (monitoring of the graft/matrix) is provided by a separate practitioner.
`56`	Preoperative management only	Use when only preoperative management is provided by a separate practitioner.
`62`	Two surgeons	Use when two surgeons of different specialties actively participate in the primary procedure and adjunct application.
`AS`	Ambulatory surgical center facility service	Use to indicate services furnished in an ASC when required by payer reporting rules.
`CO`	Routine services that are statutorily excluded	Use if applicable per payer policy (payer-specific guidance required).
`CQ`	Service furnished in a CMS special payment situation	Use when special payment indicator applies per CMS guidance.
`FX`	Service performed by the supervising physician due to trainee absence	Use in teaching settings when supervising physician performs the service because trainee is absent.

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