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    HCPCS Details

    HCPC Q4166
    Short Description Cytal, per square centimeter
    Long Description Cytal, per square centimeter
    Pricing indicator 51
    Coverage code C
    ASC payment group code
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2017-01-01
    Date Added 2017-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    86190000109 Q4166 Cytal, per square centimeter Cytal Burn Matrix ACELL, INC 1 SQ CM 25 1 25 25
    86190000110 Q4166 Cytal, per square centimeter Cytal Burn Matrix ACELL, INC 1 SQ CM 70 1 70 70
    86190000111 Q4166 Cytal, per square centimeter Cytal Burn Matrix ACELL, INC 1 SQ CM 150 1 150 150
    86190000139 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 11 1 11 11
    86190000140 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 21 1 21 21
    86190000141 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 70 1 70 70
    86190000142 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 150 1 150 150
    86190000143 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 25 1 25 25
    86190000144 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 70 1 70 70
    86190000145 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 150 1 150 150
    86190000146 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 25 1 25 25
    86190000147 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 70 1 70 70
    86190000148 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 150 1 150 150
    86190000149 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 25 1 25 25
    86190000150 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 70 1 70 70
    86190000151 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 150 1 150 150
    86190000182 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 400 1 400 400
    86190000183 Q4166 Cytal, per square centimeter Cytal Wound Matrix ACELL, INC 1 SQ CM 560 1 560 560
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 1 SQ CM
    HCPCS/CPT Billing Units 1
    Total doses ordered
    Billing Units 1