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HCPCS code Q4242: Amniocyte Plus, per 0.5 cc2026 Medicare rate & RVUs

Identifies Amniocyte Plus by volume for reporting, with each HCPCS unit representing 0.5 cc of the product.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · Q4242

Amniocyte Plus, per 0.5 cc

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for Q4242 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Medicare rate
  2. What Q4242 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Billing questions
  9. Sources

What Q4242 covers

Q4242 identifies Amniocyte Plus, a product reported by volume in half-cubic-centimeter units. It represents the quantity of product rather than an interpretation; a separate code covers interpretation. The code is reported for the amount of Amniocyte Plus associated with the service. One unit represents 0.5 cc, so 1 cc is 2 units; calculate units from the volume reported.

Medicare assigns Q4242 physician fee schedule status C, meaning there is no national payment amount and the Medicare Administrative Contractor prices each claim under the physician fee schedule. CMS classifies the code for contractor pricing under that schedule. Coverage is left to the Medicare contractor’s judgment. Q4242 is technical-component-only, and a separate code covers interpretation. Units identify the volume of Amniocyte Plus represented by the code.

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 Q4242 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

Q4242 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

Q4242 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
Q4242 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the Q4242 rate is calculated

Each of Q4242’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 · Q4242

RVUs × geographic indexes × conversion factor

Office or facility?

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 Q4242

The CMS indicators that decide how Q4242 is paid alongside other services.

CMS payment indicators · Q4242

Amniocyte Plus, per 0.5 cc

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures9The concept doesn’t apply.
Bilateral (modifier 50)9The concept doesn’t apply.
Assistant at surgery (80/81/82/AS)9The concept doesn’t apply.
Co-surgeons (62)9The concept doesn’t apply.
Team surgery (66)9The concept doesn’t apply.
Professional/technical3Technical component only.

Q4242 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • Q4242

    Amniocyte Plus, per 0.5 cc0 wRVU

    Not priced

  • Q4240

    Corecyte, topical, per 0.5 cc0 wRVU

    Not priced

  • Q4241

    Polycyte, topical, per 0.5 cc0 wRVU

    Not priced

  • Q4245

    Amniotext, per cc0 wRVU

    Not priced

  • Q4247

    Amniotext patch, per square centimeter0 wRVU

    $127.26

How to choose

Q4240CorecyteTopical, per 0.5 cc
Q4240 identifies Corecyte for topical use. Q4242 identifies Amniocyte Plus; select the code for the product reported.
Q4241PolycyteTopical, per 0.5 cc
Q4241 identifies Polycyte for topical use. Q4242 identifies Amniocyte Plus; select the code for the product reported.
Q4245AmniotextPer cc
Q4245 identifies Amniotext and is measured per cc. Q4242 identifies Amniocyte Plus and is measured per 0.5 cc.
Q4247Amniotext patchPer square centimeter
Q4247 identifies an Amniotext patch measured by area. Q4242 identifies Amniocyte Plus measured by volume.

Q4242 billing questions

How many units represent 1 cc?

Each unit represents 0.5 cc, so 1 cc corresponds to 2 units. Calculate units from the volume reported.

Is interpretation included in Q4242?

No. Q4242 is technical-component-only; a separate code covers interpretation.

How does Medicare price Q4242?

The physician fee schedule status is C, meaning CMS publishes no national payment amount. The Medicare Administrative Contractor prices each claim under the physician fee schedule.

How is Q4242 different from Q4240?

Q4240 identifies Corecyte for topical use. Q4242 identifies Amniocyte Plus; select the code for the product reported.

Does Medicare coverage apply automatically?

Coverage is left to the Medicare contractor’s judgment.

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

Open CMS sourceHow we calculate rates

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