A4100: Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)
A4100 is a HCPCS Level II code for non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure). It belongs to the Transportation, Medical & Surgical Supplies, Administrative 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 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusC
Contractor-priced. Your MAC establishes the RVUs and the payment amount case by case, usually after reviewing documentation. There is no national amount to compute.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for A4100
- Long descriptor
- Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)
- Short descriptor
- Nosht skin sub fda clrd nos
- Added
- April 1, 2022
- BETOS
- P5A
- Pricing indicator
- 13: 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 by carriers, not otherwise classified, individual determination, or carrier discretion.
Codes adjacent to A4100
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If A4100 is not quite right, the correct code is very often within a few positions of it.
- A2043Biobrane (add-on, list separately in addition to primary procedure), per square centimeter
- A2044Biobrane glove, each
- A2045Novashield or novogen wound matrix (add-on, list separately in addition to primary procedure), per square centimeter
- A2046Dermisphere hdrt, per square centimeter (add-on, list separately in addition to primary procedure)
- A2047Lacertamatrix, per square centimeter (add-on, list separately in addition to primary procedure)
- A2048Puraply mz, per milligram
- A2049Theracor, per square centimeter (add-on, list separately in addition to primary procedure)
- A2050Fibrillar collagen wound dressing, per milligram
- A4206Syringe with needle, sterile, 1 cc or less, each
- A4207Syringe with needle, sterile 2 cc, each
- A4208Syringe with needle, sterile 3 cc, each
- A4209Syringe with needle, sterile 5 cc or greater, each
- A4210Needle-free injection device, each
- A4211Supplies for self-administered injections
- A4212Non-coring needle or stylet with or without catheter
- A4213Syringe, sterile, 20 cc or greater, each