Q4202: Keroxx (2.5g/cc), 1cc
Q4202 is a HCPCS Level II code for keroxx (2.5g/cc), 1cc. 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 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 Q4202
- Long descriptor
- Keroxx (2.5g/cc), 1cc
- Short descriptor
- Keroxx (2.5g/cc), 1cc
- Added
- January 1, 2019
- BETOS
- O1E
- 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 Q4202
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If Q4202 is not quite right, the correct code is very often within a few positions of it.
- Q4194Novachor, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4195Puraply, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4196Puraply am, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4197Puraply xt, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4198Genesis amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4199Cygnus matrix, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4200Skin te, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4201Matrion, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4203Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4204Xwrap, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4205Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4206Fluid flow or fluid gf, 1 cc
- Q4207Carbon life, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4208Novafix, per square cenitmeter (add-on, list separately in addition to primary procedure)
- Q4209Surgraft, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4210Axolotl graft or axolotl dualgraft, per square centimeterterminated