Q4180 Revita Skin Substitute Fee Change

Palmetto GBA completed a fee review for HCPCS code Q4180 under the Jurisdiction J contract. The July 2020 fees for HCPCS Code Q4180 were revised to reflect a decrease based on methodology changes that require a drop in price. Claims received for dates of service July 1, 2020, and after are reimbursed based on the following fees and effective dates.

Previously, we notified providers that the fee for HCPCS code Q4180 effective July 1, 2020, would be $145.927. Updated pricing information was made available since that original notification. The new fee is detailed below.

HCPCS code Q4180 - Revita

Contractor Fee
Effective for Dates of Service
7/1/20 and after

Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.

Last Updated: 07/07/2020