Descriptors and administrative fields exactly as published in the CMS HCPCS quarterly file.
Billing context: Q-codes
Units are reported in multiples of the dosage in the code descriptor.
One HCPCS billing unit of Q4155
1 MG
No published MUE for Q4155. CMS keeps some MUE values confidential, so this does not mean there is no daily unit limit.
Medicare Part B drug payment limits per billing unit, by quarter, from the CMS payment limit (ASP) files.
Most recent Medicare Part B payment limit · Q4 2025
$26.624per 1 MG
Effective Oct 1, 2025 – Dec 31, 2025 · ASP methodology (per CMS file) · based on Q2 2025 ASP data · coinsurance 20.000%
Not in the latest payment limit file (Q4 2026). Shown for history only.
| Quarter | Effective | Payment limit | Per (billing unit) | Coinsurance | Change | CMS notes |
|---|---|---|---|---|---|---|
| Q4 2025 | Oct 1, 2025 – Dec 31, 2025 | $26.624 | 1 MG | 20% | −2.5% | — |
| Q3 2025 | Jul 1, 2025 – Sep 30, 2025 | $27.310 | 1 MG | 20% | +3.8% | — |
| Q2 2025 | Apr 1, 2025 – Jun 30, 2025 | $26.309 | 1 MG | 20% | −8.4% | — |
| Q1 2025 | Jan 1, 2025 – Mar 31, 2025 | $28.723 | 1 MG | 20% |
Medicare hospital outpatient (OPPS) · Q4 2026
N Packaged: no separate payment
Washington Apple Health · professional claims
Not on HCA's professional administered drug fee schedule.
AAC = actual acquisition cost, based on NDC or invoice; BR = by report; NC = not covered; DC = not covered, see a different code; DP = covered under another program (see comments); PA = prior authorization; EPA = expedited prior authorization (see the billing guide); CPA = contractor prior authorization (Qualis). For professional claims; hospital-administered drugs are paid under HCA's outpatient (OPPS/EAPG) rules.
Packages CMS assigns to this code in its NDC–HCPCS crosswalks, with billable units per package. Only official crosswalk rows are shown.
No CMS NDC–HCPCS crosswalk rows were located. CMS notes its crosswalks are not a comprehensive list of all NDCs.
| NDC (11-digit) | CMS drug name · labeler | Pkg size × qty | Units / item | Units / NDC | Crosswalk | Quarters | FDA listing |
|---|---|---|---|---|---|---|---|
| 00855928005367 alt ID | Neox FloBioTissue | 25 × 1 | 25 | 25 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005374 alt ID | Neox FloBioTissue | 50 × 1 | 50 | 50 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005381 alt ID | Neox FloBioTissue | 100 × 1 | 100 | 100 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005398 alt ID | Neox FloBioTissue | 150 × 1 | 150 | 150 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005404 alt ID | Clarix FloBioTissue | 25 × 1 | 25 | 25 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005411 alt ID | Clarix FloBioTissue | 50 × 1 | 50 | 50 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005428 alt ID | Clarix FloBioTissue | 100 × 1 | 100 | 100 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
| 00855928005671 alt ID | Neox FloBioTissue | 10 × 1 | 10 | 10 | ASP | Q3 2024 – Q4 2025Not in Q4 2026 file | Not found |
Medicare coverage is set nationally (NCDs) and by each Medicare Administrative Contractor (LCDs and Billing & Coding articles). These links open the official documents.
Verification neededCodeRx links to coverage documents instead of copying them: CMS distributes their code lists under AMA, ADA, and AHA license terms that limit reuse. Medicare Advantage, Medicaid, and commercial plans set their own coverage and prior-authorization rules.
Changes detected between the CMS quarterly HCPCS files CodeRx has imported.
| Quarterly file | Change | CMS action code | Details |
|---|---|---|---|
| Q1 2026 | Dates changed | P — Payment change | Added Jan 1, 2015 · action effective Jan 1, 2026 · termination — |
| Q1 2023 | In earliest ingested file | N — No maintenance | Added date Jan 1, 2015 |
All imported releases, checksums, and import reports are listed on the data sources page.
Disclaimer. This application provides informational coding and reimbursement reference data. It does not constitute legal, clinical, coding, or billing advice. Codes, payment amounts, payer rules, and coverage policies can change. Verify all information with current CMS publications, the applicable payer, and your organization’s compliance policies before submitting a claim. CodeRx is not affiliated with or endorsed by CMS, FDA, Medicare, or any payer.
| +9.1% |
| — |
| Q4 2024 | Oct 1, 2024 – Dec 31, 2024 | $26.327 | 1 MG | 20% | +20.7% | — |
|---|
| Q3 2024 | Jul 1, 2024 – Sep 30, 2024 | $21.820 | 1 MG | 20% | — | Added July 2024 |
|---|