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Complete skin substitute code universe built from CMS rulemaking: - 286 Q4 product codes (Q4100-Q4397): 283 active, 3 deleted - 34 reference codes: CPT 15271-15278 (application), C5271-C5278 (deleted Jan 2026), historical CPT 15330-15430 - Columns: hcpcs_code, short_descriptor, product_name, manufacturer, category, fda_pathway, effective_date, termination_date, status, notes - Loaded into DuckDB as skin_subs.hcpcs_universe and skin_subs.hcpcs_reference Key finding: 213/283 active products (75%) are amniotic membrane — the dominant category and the one most implicated in fraud cases. FDA pathway: 249 HCT/P (Section 361), 28 510(k), 5 PMA Refs #232