Summary & Overview
HCPCS Q4375: Duograft ac, Per Square Centimeter (Add-On)
HCPCS Level II code Q4375 identifies Duograft ac billed per square centimeter as an add-on graft product supplied in addition to a primary surgical procedure. As an HCPCS Level II supply code, Q4375 captures usage of a biologic graft measured by area rather than by unit, which affects how facilities and payers process and price these adjunctive products. Nationwide, supply and biologic add-on codes like Q4375 are important for accurate clinical documentation, procurement accounting, and payer adjudication for procedures that require supplemental graft materials.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical intent and service setting, common modifier usage where available, and an outline of what typical coverage review and billing considerations involve. The publication provides benchmarks and payment context where available, notes common billing practices for graft products, and summarizes payer approaches to add-on supply codes. Data not available in the input are flagged accordingly. This piece is written for a national audience seeking clarity on coding, billing workflows, and payer interactions related to graft product add-on billing.
Billing Code Overview
HCPCS Level II code Q4375 represents Duograft ac, billed per square centimeter and is designated as an add-on, list separately in addition to primary procedure. The code describes a graft product supplied and billed by area of application rather than a single-use or bundled item.
Service Type: Graft product / biologic ancillary supply
Typical Site of Service: Operative settings (inpatient or outpatient surgical procedures where a graft product is applied as an adjunct to a primary procedure).
Clinical & Coding Specifications
Clinical Context
A middle-aged patient with a full-thickness lower-extremity soft tissue defect after wide excision of a chronic non-healing diabetic foot ulcer undergoes surgical debridement and preparation of the wound bed in the operating room. After hemostasis and measurement of the defect, the surgeon elects to apply an acellular dermal matrix product (Duograft AC) as a biologic graft to augment soft-tissue coverage and facilitate granulation and re-epithelialization. The service is billed as an add-on product by square centimeter using Q4375 in addition to the primary procedure. Typical workflow includes preoperative assessment, intraoperative measurement of the graft area, placement and securement of the graft to the prepared wound bed, and postoperative wound care with scheduled clinic follow-up for dressing changes and assessment of graft integration.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Used when no specific modifier applies and services are reported as usual. |
22 | Increased procedural services | Use when the work required to place the graft is substantially greater than typical (complex reconstruction, extensive debridement beyond usual).
| Reduced services | Use when the graft application is partially reduced or limited compared with the usual procedure.