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Updated October 1st, 2026

Integra Bilayer Wound Matrix Q Code: Q4104

Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure)

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Medicare Payment Limit ?
Not published
CMS publishes none for Q4 2026
APC Payment Limit ?
$127.14
/ HCPCS billing unit · APC 6001
ASP ?
No current ASP
Not available for Q4 2026
WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
8
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Drug & Product Overview

HCPCS Descriptor Integra bilayer matrix wound dressing (bmwd), per square centimeter (add-on, list separately in addition to primary procedure)
HCPCS Added Date January 1, 2009
Manufacturer Integra Lifesciences
Route of Administration Topical
Generic Status Single-Source; Branded

About Integra Bilayer Wound Matrix

Integra Bilayer Wound Matrix is a medication aligned to the HCPCS Q Code: Q4104 for billing, pricing, and reimbursement purposes in the United States. It is a Wound Care drug administered via the topical route and manufactured by Integra Lifesciences.

According to CMS Drug Use Information: Drug uses not available

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

8 NDC packages are crosswalked to Q4104. Package detail is available to logged-in subscribers.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
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Integra Bilayer Wound Matrix
Integra Bilayer Wound Matrix
Integra Bilayer Wound Matrix
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Not on the CMS JW / JZ list

CMS does not include Integra Bilayer Wound Matrix (Q4104) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q4104. Wastage billing guide →

Integra Bilayer Wound Matrix Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Partial- and full-thickness wounds Pressure ulcers Venous ulcers Diabetic ulcers Chronic vascular ulcers Surgical wounds (donor sites, grafts, post-Mohs surgery, post-laser surgery, podiatric wounds, wound dehiscence) Trauma wounds (abrasions, lacerations, second-degree burns, skin tears) Draining wounds

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Frequently Asked Questions

Is there an available Integra Bilayer Wound Matrix billing and coding guide?
Billing and coding information for Integra Bilayer Wound Matrix can be found through Integra Lifesciences. Visit Here →
Are there any available Integra Bilayer Wound Matrix patient assistance programs?
Our team has not identified a manufacturer-published source of patient assistance information for Integra Bilayer Wound Matrix.
Where can I find Integra Bilayer Wound Matrix prescribing information?
Integra Bilayer Wound Matrix prescribing information can be found at the link below: Visit Here →
Where can I find Integra Bilayer Wound Matrix side effect information?
Our team has not yet identified a source of side effects information for Integra Bilayer Wound Matrix. Please check back in a few weeks.
Does billing Integra Bilayer Wound Matrix require JZ/JW wastage modifiers?
CMS does not include Integra Bilayer Wound Matrix (Q4104) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q4104. For more information, visit the link below.

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