HCPCS code Q4235: Wound tissue product, amniorepair or Altiply2026 Medicare rate & RVUs in Missouri
Reports Amniorepair or Altiply wound-coverage product by square centimeter when supplied with a primary wound application procedure.
Medicare pays $109.70–$121.15 for Q4235 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
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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On this page 9 sections
What Q4235 covers
Q4235 identifies Amniorepair or Altiply wound-coverage product supplied by square centimeter; it represents the product, not the work of placing it. These products may be used as biologic coverings during treatment of open wounds, including chronic ulcers. A wound-care physician, surgeon, or other qualified practitioner may apply the product to a prepared wound bed in an office or hospital outpatient setting as part of a wound procedure. The associated application service is reported separately.
Report Q4235 only with a qualifying primary application procedure. CMS classifies it as an add-on code and pays it within that procedure’s global period, so it is not a stand-alone service. Select the code based on the product supplied and report units on a per-square-centimeter basis. Documentation should identify the product, wound site, amount used, and primary procedure. CMS classifies Q4235 as technical-component-only; a separate code covers interpretation.
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.
Where Q4235 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$109.70 to $121.15
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $119.49 | Unavailable |
| Metropolitan St. Louis, MO | $121.15 | Unavailable |
| Rest of Missouri | $109.70 | Unavailable |
How the Q4235 rate is calculated
Each of Q4235’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 · Q4235
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense3.81
3.81 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
3.8100
Conversion factor
$33.4009
Medicare rate
$127.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4235
The CMS indicators that decide how Q4235 is paid alongside other services.
CMS payment indicators · Q4235
Wound tissue product, amniorepair or Altiply
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4235 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4234Wound productXcellerate, per square centimeter
- Q4234 identifies Xcellerate; Q4235 identifies Amniorepair or Altiply. Select by the product supplied, not by the wound site.
- Q4236CarepatchPer square centimeter
- Q4236 identifies Carepatch, while Q4235 identifies Amniorepair or Altiply. Both use a per-square-centimeter unit, but the product determines the code.
- Q4230Cogenex flowable amnionPer 0.5 cc
- Q4230 identifies Cogenex Flow amnion and is measured per 0.5 cc; Q4235 identifies Amniorepair or Altiply and is measured per square centimeter.
Q4235 billing questions
Does Q4235 describe applying the product?
No. It identifies the Amniorepair or Altiply product; report the wound application service separately as the primary procedure.
What determines whether Q4235 is the right product code?
Use Q4235 when the product supplied is Amniorepair or Altiply. Do not select it solely from wound location or type.
How are units reported?
The code is measured per square centimeter. Document the product amount used and the wound site.
Can Q4235 be billed without a primary procedure?
No. CMS identifies it as an add-on code that is billed with a primary procedure and paid within that procedure’s global period.
Does Q4235 include interpretation?
No. CMS classifies Q4235 as technical-component-only; a separate code covers interpretation.
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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