HCPCS code Q4358: Wound product, xwrap Dual, per square centimeter2026 Medicare rate & RVUs in Missouri
Reports the area of Xwrap Dual wound-care product used with a primary wound application procedure, measured in square centimeters.
Medicare pays $109.70–$121.15 for Q4358 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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What Q4358 covers
Q4358 identifies the Xwrap Dual wound-care product by the area used, rather than the clinician’s work to prepare or apply it. It may be reported when a wound-care clinician or surgeon uses the product during treatment of a wound, including in an office or hospital outpatient setting. The clinical record should identify the treated wound and the product used.
Report the product with a primary application procedure; Q4358 is an add-on code and is not billed by itself. Document the quantity in square centimeters so the units match the area used. CMS places payment within the primary procedure’s global period. Q4358 is classified as technical-component-only, with a separate code covering 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 Q4358 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 Q4358 rate is calculated
Each of Q4358’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 · Q4358
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 Q4358
The CMS indicators that decide how Q4358 is paid alongside other services.
CMS payment indicators · Q4358
Wound product, xwrap Dual, 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. |
Q4358 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4357Wound matrixXwrap Plus, per square centimeter
- Q4357 identifies Xwrap Plus; Q4358 identifies Xwrap Dual. Report the code matching the product used.
- Q4359Wound matrixChoriply, per square centimeter
- Q4359 identifies Choriply, a different wound-care product. Choose Q4358 only when the product used is Xwrap Dual.
- 15271Skin substitute graftFirst 25 cm², trunk/limbs
- 15271 reports the primary application service for qualifying wound areas; Q4358 reports the Xwrap Dual product used with a primary procedure.
Q4358 billing questions
Can Q4358 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure, such as the applicable wound-product application code.
How should the units be determined?
Base the units on the square centimeters of Xwrap Dual used, supported by documentation of the treated area and product quantity.
How does Q4358 differ from Q4357?
Q4358 identifies Xwrap Dual, while Q4357 identifies Xwrap Plus. Select the code for the specific product used.
Is interpretation included in Q4358?
CMS classifies Q4358 as technical-component-only; a separate code covers interpretation.
How is payment handled with the primary procedure?
Q4358 is paid within the primary procedure’s global period and must be paired with that procedure.
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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