HCPCS code Q4242: Amniocyte Plus, per 0.5 cc2026 Medicare rate & RVUs in Oregon
Identifies Amniocyte Plus by volume for reporting, with each HCPCS unit representing 0.5 cc of the product.
CMS doesn’t publish an office rate for Q4242 in Oregon.
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 8 sections
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 in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | Unavailable |
| Rest of Oregon | Unavailable | Unavailable |
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
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
| 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. |
Q4242 compared with similar codes
Compare codes · National
5 codes, side by side
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
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