Q4350 Palisade Dermal Matrix HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS Q4350: Palisade Dermal Matrix, Per Square Centimeter

HCPCS Level II code Q4350 identifies the Palisade dermal matrix billed per square centimeter as an add-on supply used in reconstructive procedures. As a supply-level add-on code, Q4350 supplies are reported in addition to the primary surgical procedure when a dermal scaffold is implanted to support soft-tissue repair. This code matters nationally because dermal matrices are increasingly used across plastic, reconstructive, and wound-care services and can materially affect procedure-level resource use and payer coverage determinations.

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, typical sites of service, and billing context. The publication outlines common modifiers and billing considerations, summarizes payer coverage patterns where available, and highlights how Q4350 functions as a per-square-centimeter add-on that can influence claim line pricing for reconstructive surgeries.

This summary equips billing, coding, and revenue-cycle professionals with the essential clinical and coding context for HCPCS Level II code Q4350, and orients readers to the operational and payer-related factors they should review when this dermal matrix product is used.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareQ4350HCPCS Level IIdermal matrixreconstructive surgeryadd-on supplywound caresurgical implantper square centimetermedical billing

Billing Code Overview

HCPCS Level II code Q4350 describes a Palisade dermal matrix product billed per square centimeter as an add-on, list separately in addition to primary procedure. The code represents a biologic dermal scaffold used to support soft-tissue reconstruction and wound closure when documented as an adjunct to a primary surgical or reconstructive procedure.

Service Type: Dermal matrix implant / adjunctive soft-tissue reconstruction material

Typical Site of Service: Hospital outpatient surgery, ambulatory surgical center, or inpatient surgical setting where a primary procedure requiring soft-tissue reinforcement is performed.

Clinical & Coding Specifications

Clinical Context

A patient with a full-thickness skin defect from trauma or a surgical excision requires application of a dermal regenerative template. In the clinic or operating room, a reconstructive surgeon or wound care specialist prepares the wound bed, achieves hemostasis, and applies the palisade dermal matrix product, billed as Q4350 per square centimeter as an add-on to the primary procedure. Typical workflow: preoperative assessment and wound prep, debridement or excision (primary procedure), measurement of defect area for Q4350 billing, placement and fixation of the dermal matrix, possible concurrent skin grafting (autograft) or negative-pressure wound therapy, and postoperative dressing and follow-up for incorporation and graft take. Typical sites of service include hospital operating rooms, ambulatory surgical centers, and specialized wound care clinics. A realistic patient scenario: a 58-year-old patient with a traumatic lower-extremity full-thickness soft tissue defect undergoes surgical debridement and application of a dermal regenerative matrix (Q4350) followed by a split-thickness skin graft during the same operative session.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services

HCPCS Q4380: Advograft per Square Centimeter Graft

HCPCS-Q4130-STRATTICE-PER-SQUARE-CENTIMETER-SURGICAL-MESH

HCPCS Q4130: Strattice™ Per Square Centimeter, Surgical Mesh

HCPCS-Q4415-ALEXIGUARD-TOPICAL-PER-SQ-CM-ADD-ON

HCPCS Q4415: Alexiguard topical per square centimeter (add-on)

HCPCS-Q4366-DUAL-LAYER-AMNIO-MEMBRANE-GRAFT-PER-CM2

HCPCS Q4366: Dual Layer Amnio Membrane Graft, Per cm2

HCPCS-Q4432-510K-SKIN-SUBSTITUTE-PRODUCT-ADJUNCT-PROCEDURE

HCPCS Level II Q4432: 510(k) Skin Substitute Product, Adjunct

HCPCS-Q4175-MIRODERM-PER-SQUARE-CENTIMETER

HCPCS Level II Q4175: Miroderm, per Square Centimeter

HCPCS-Q9981-ROLAPITANT-ORAL-1MG-ANTIEMETIC

HCPCS Level II Q9981: Rolapitant, Oral, 1 mg

HCPCS-Q4353-XCEED-TL-MATRIX-WOUND-MANAGEMENT-PER-SQ-CM

HCPCS Q4353: Xceed tl Matrix, Wound Management Add-On

HCPCS-Q4347-RAMPART-DL-MATRIX-PER-SQ-CM

HCPCS Q4347: Rampart dl Matrix, per Square Centimeter

HCPCS-Q4180-REVITA-PER-SQUARE-CENTIMETER-ADD-ON

HCPCS Q4180: Revita, per Square Centimeter (Add-on Product)

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Taxonomy Code	Specialty	Notes
`208000000X`	General Surgery	Commonly performs debridement, soft-tissue reconstruction, and application of dermal matrices.
`207P00000X`	Plastic Surgery	Frequently performs complex reconstruction and grafting using dermal regenerative templates.
`208600000X`	Trauma Surgery	Manages traumatic soft-tissue defects requiring dermal matrices in the acute setting.
`173100000X`	Wound Care Specialist	Applies dermal matrices in clinic or procedural settings as part of chronic wound management.
`207K00000X`	Orthopaedic Surgery	May be involved for limb injuries requiring soft-tissue reconstruction with matrix support.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`T79.8XXA`	Other early complication of trauma, initial encounter	Relevant for acute traumatic wounds requiring dermal matrix placement to reconstruct soft-tissue defects.
`S81.811A`	Complex open wound of right lower leg, initial encounter	Full-thickness lower-extremity wounds often require dermal regenerative matrices to restore dermal layer before grafting.
`L97.521`	Non-pressure chronic ulcer of right lower leg with necrosis of muscle	Chronic non-healing ulcers with full-thickness tissue loss may be managed with dermal matrices to promote regeneration.
`T86.891`	Other complications of transplanted tissue and organs	Relevant when dermal matrices are used in reconstructive procedures and there are complications requiring reintervention.
`C44.311`	Squamous cell carcinoma of right lower eyelid, initial encounter for excision	Surgical excision of skin cancers producing full-thickness defects where a dermal matrix is used as part of reconstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue, first 20 sq cm or less	Often performed prior to placement of the dermal matrix to prepare a clean, viable wound bed.
`15271`	Application of a regenerative tissue matrix to trunk, arms, legs, complex	Commonly billed for application of an acellular dermal matrix or biologic scaffold when a distinct CPT applies alongside `Q4350`.
`15275`	Application of a regenerative tissue matrix, each additional 100 sq cm or less	Used when larger surface area requires additional matrix material beyond initial sizing in the same operative session.
`15002`	Adjacent tissue transfer or rearrangement, trunk; first 100 sq cm	May be performed in conjunction with matrix placement during reconstructive closure.
`15100`	Split-thickness autograft, trunk, arms, legs; first 100 sq cm	Frequently performed after or with placement of the dermal matrix to provide epithelial coverage and facilitate wound closure.

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