HCPCS code Q4249: Amniply, per square centimeter2026 Medicare rate & RVUs in Illinois
Reports the Amniply amniotic membrane product by square centimeter when furnished for application to a wound during a separately coded wound procedure.
Medicare pays $116.19–$130.69 for Q4249 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. 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 Q4249 covers
Q4249 represents the Amniply amniotic membrane product supplied for wound treatment, measured by the square centimeter. Wound-care clinicians, surgeons, and podiatrists may use it when applying the product to a prepared wound bed in an office or other treatment setting. The code identifies the product, not the wound preparation or application service itself.
Report the number of square centimeters represented by the Amniply product furnished, and retain documentation identifying the product and supporting the quantity reported. CMS classifies Q4249 as an add-on code: bill it only with a primary procedure, such as an applicable skin-substitute application procedure, and payment is within that procedure’s global period. It is a technical-component-only code; 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 Q4249 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$116.19 to $130.69
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $127.89 | Unavailable |
| East St. Louis, IL | $117.08 | Unavailable |
| Rest of Illinois | $116.19 | Unavailable |
| Suburban Chicago, IL | $130.69 | Unavailable |
How the Q4249 rate is calculated
Each of Q4249’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 · Q4249
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 Q4249
The CMS indicators that decide how Q4249 is paid alongside other services.
CMS payment indicators · Q4249
Amniply, per square centimeter
| 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. |
Q4249 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4247Amniotext patchPer square centimeter
- Q4247 identifies Amniotext patch, while Q4249 identifies Amniply. Use the code matching the product furnished.
- Q4248Wound allograftPer square centimeter
- Q4248 identifies Dermacyte amniotic membrane allograft. Q4249 is specific to Amniply; the similar tissue category does not make the product codes interchangeable.
- Q4239Amniotic graftAmnio-Maxx or Lite, per square centimeter
- Q4239 identifies Amnio-maxx or lite rather than Amniply. Select according to the product used, not just the shared square-centimeter billing unit.
Q4249 billing questions
How is Q4249 different from the skin-substitute application code?
Q4249 reports the Amniply product by square centimeter. The primary application code reports the wound application service.
Can Q4249 be billed by itself?
No. CMS identifies Q4249 as an add-on code that must be billed with a primary procedure.
What quantity should be reported?
Report the square centimeters of Amniply product furnished. Documentation should identify the product and support the quantity.
Is a separate interpretation code needed?
CMS classifies Q4249 as technical-component-only and specifies that a separate code covers interpretation.
How does the global-period rule affect payment?
Payment for Q4249 is within the primary procedure’s global period, so it is not paid separately from that procedure’s global payment.
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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