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Updated July 1st, 2026

OASIS ULTRA TRI-LAYER MATRIX Q Code: Q4124

Oasis ultra tri-layer wound matrix, 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 Q3 2026
APC Payment Limit ?
$127.14
/ HCPCS billing unit · APC 6001
ASP ?
No current ASP
Not available for Q3 2026
WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
5
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Drug & Product Overview

HCPCS Descriptor Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)
HCPCS Added Date January 1, 2012
Manufacturer Smith & Nephew
Generic Status Single-Source; Branded

About OASIS ULTRA TRI-LAYER MATRIX

Oasis Ultra Tri-layer Matrix is a medication aligned to the HCPCS Q Code: Q4124 for billing, pricing, and reimbursement purposes in the United States. It is a Wound Care drug manufactured by Smith & Nephew.

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

5 NDC packages are crosswalked to Q4124. Package detail is available to logged-in subscribers.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
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OASIS ULTRA TRI-LAYER MATRIX
OASIS ULTRA TRI-LAYER MATRIX
OASIS ULTRA TRI-LAYER MATRIX
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OASIS ULTRA TRI-LAYER MATRIX Pricing & Reimbursement

Q4124 Private Payer Reimbursement
$6.70 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna
Not on the CMS JW / JZ list

CMS does not include Oasis Ultra Tri-layer Matrix (Q4124) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q4124. Wastage billing guide →

OASIS ULTRA TRI-LAYER 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 Tunneled/undermined wounds Surgical wounds (donor sites/grafts; post-Mohs; post-laser; podiatric; wound dehiscence) Trauma wounds (abrasions; lacerations; second-degree burns; skin tears) Draining wounds

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Frequently Asked Questions

Is there an available Oasis Ultra Tri-Layer Matrix billing and coding guide?
Billing and coding information for OASIS ULTRA TRI-LAYER MATRIX can be found through Smith & Nephew. Visit Here →
Are there any available Oasis Ultra Tri-Layer Matrix patient assistance programs?
Our team has not identified a manufacturer-published source of patient assistance information for OASIS ULTRA TRI-LAYER MATRIX.
Where can I find Oasis Ultra Tri-Layer Matrix prescribing information?
OASIS ULTRA TRI-LAYER MATRIX prescribing information can be found at the link below: Visit Here →
Where can I find Oasis Ultra Tri-Layer Matrix side effect information?
Our team has not yet identified a source of side effects information for OASIS ULTRA TRI-LAYER MATRIX. Please check back in a few weeks.
Does billing OASIS ULTRA TRI-LAYER MATRIX require JZ/JW wastage modifiers?
CMS does not include OASIS ULTRA TRI-LAYER MATRIX (Q4124) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing Q4124. For more information, visit the link below.

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