HCPCS code Q4230: Cogenex flowable amnion, per 0.5 cc2026 Medicare rate & RVUs in Guam
Cogenex flowable amnion is reported by volume, with each Q4230 unit representing 0.5 cc and Medicare payment and coverage determined by the contractor.
CMS doesn’t publish an office rate for Q4230 in Guam.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What Q4230 covers
Q4230 identifies Cogenex flowable amnion as a product reported by volume. Each claim unit represents 0.5 cc, making the billed quantity a measure of product volume. This distinguishes Q4230 from Q4229, which identifies Cogenex amniotic membrane by surface area. For example, 1 cc of Cogenex flowable amnion corresponds to 2 Q4230 units. The code identifies the product quantity; CMS classifies it as technical-component-only, with interpretation covered by a separate code.
Medicare lists Q4230 as carrier priced (status C), meaning the Medicare Administrative Contractor sets payment for each claim. CMS assigns contractor pricing under the physician fee schedule and leaves coverage to the contractor's judgment. Thus, payment and coverage determinations are made by the contractor, while reported units reflect 0.5 cc each.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Q4230 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
How the Q4230 rate is calculated
Each of Q4230’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · Q4230
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4230
The CMS indicators that decide how Q4230 is paid alongside other services.
CMS payment indicators · Q4230
Cogenex flowable amnion, per 0.5 cc
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 9 | The concept doesn’t apply. |
| Bilateral (modifier 50) | 9 | The concept doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 9 | The concept doesn’t apply. |
| Co-surgeons (62) | 9 | The concept doesn’t apply. |
| Team surgery (66) | 9 | The concept doesn’t apply. |
| Professional/technical | 3 | Technical component only. |
Q4230 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4229Amniotic membraneCogenex, per square centimeter
- Q4230 identifies Cogenex flowable amnion measured by volume; Q4229 identifies Cogenex amniotic membrane measured by surface area.
- Q4233Surfactor or NudynPer 0.5 cc
- Both codes use 0.5 cc units, but Q4233 identifies Surfactor or Nudyn rather than Cogenex flowable amnion.
- Q4242Amniocyte PlusPer 0.5 cc
- Q4242 identifies Amniocyte Plus. Q4230 identifies Cogenex flowable amnion.
Q4230 billing questions
How many Q4230 units represent 1 cc?
Each unit represents 0.5 cc, so 1 cc corresponds to 2 units.
How does Q4230 differ from Q4229?
Q4230 identifies Cogenex flowable amnion measured by volume. Q4229 identifies Cogenex amniotic membrane measured by surface area.
Does Q4230 include interpretation?
No. CMS classifies Q4230 as technical-component-only; a separate code covers interpretation.
Who determines Medicare payment and coverage?
The Medicare Administrative Contractor sets payment for each claim and makes the coverage determination.
What quantity should documentation support?
Document the Cogenex flowable amnion and the volume represented by the billed units, with each unit representing 0.5 cc.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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