Q4301 — Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Q4301 is a HCPCS Level II code for activate matrix, per square centimeter (add-on, list separately in addition to primary procedure). It belongs to the Temporary Codes section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusA
Active code. Paid separately under the physician fee schedule.
- Work RVU
- 0.00
- PE (non-facility)
- 3.81
- PE (facility)
- 3.81
- Malpractice RVU
- 0.00
Global period: ZZZ
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for Q4301
- Long descriptor
- Activate matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Short descriptor
- Activate matrix, per sq cm
- Added
- January 1, 2024
- BETOS
- O1E
- Pricing indicator
- 11 — Physician fee schedule
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Price established using national RVUs.
Codes adjacent to Q4301
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q4301 is not quite right, the correct code is very often within a few positions of it.
- Q4293Acesso dl, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4294Amnio quad-core, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4295Amnio tri-core amniotic, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4296Rebound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4297Emerge matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4298Amniocore pro, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4299Amniocore pro+, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4300Acesso tl, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4302Complete aca, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4303Complete aa, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4304Grafix plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4305American amnion ac tri-layer, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4306American amnion ac, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4307American amnion, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4308Sanopellis, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4309Via matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Questions about Q4301
What is HCPCS code Q4301?
Q4301 is a HCPCS Level II code for activate matrix, per square centimeter (add-on, list separately in addition to primary procedure). It sits in the Temporary Codes section.
Does Medicare cover Q4301?
The CMS HCPCS file marks Q4301 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is Q4301 paid under the physician fee schedule?
Q4301 carries PFS status code A. Active code. Paid separately under the physician fee schedule.