HCPCS code Q4364: Amniotic membrane, XPL product, per square centimeter2026 Medicare rate & RVUs in California
Reports the AmnioBurrx XPL amniotic membrane product by square centimeter when supplied for application to a wound during a primary procedure.
Medicare pays $139.47–$183.51 for Q4364 in the office in California, from Bakersfield, CA to Santa Clara County, CA. 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 Q4364 covers
Q4364 identifies the AmnioBurrx XPL amniotic membrane product, reported by the square centimeter. It represents the wound-covering product, not the clinician’s work to prepare the wound or apply the material. A physician or other qualified practitioner may use an amniotic membrane product during treatment of a wound, such as a chronic ulcer, in an office or outpatient setting. The product code is distinct from codes describing the application service.
Report the measured amount of product used in square-centimeter units and pair Q4364 with the applicable primary procedure. CMS treats this as an add-on code paid within the primary procedure’s global period. CMS also classifies it as technical-component-only, with a separate code covering interpretation. Documentation should identify the product, wound treated, amount applied, and the associated primary procedure so the billed units and pairing are supported.
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 Q4364 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$139.47 to $183.51
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $139.47 | Unavailable |
| Chico, CA | $139.47 | Unavailable |
| El Centro, CA | $139.47 | Unavailable |
| Fresno, CA | $139.47 | Unavailable |
| Hanford, CA | $139.47 | Unavailable |
| Los Angeles, CA | $150.55 | Unavailable |
| Madera, CA | $139.47 | Unavailable |
| Marin County, CA | $179.43 | Unavailable |
| Merced, CA | $139.47 | Unavailable |
| Modesto, CA | $139.47 | Unavailable |
| Napa, CA | $167.73 | Unavailable |
| Oxnard, CA | $150.42 | Unavailable |
| Redding, CA | $139.47 | Unavailable |
| Rest of California | $139.47 | Unavailable |
| Riverside, CA | $139.47 | Unavailable |
| Sacramento, CA | $148.00 | Unavailable |
| Salinas, CA | $147.49 | Unavailable |
| San Benito County, CA | $183.51 | Unavailable |
| San Diego, CA | $152.20 | Unavailable |
| San Francisco, CA | $179.43 | Unavailable |
| San Luis Obispo, CA | $144.95 | Unavailable |
| Santa Clara County, CA | $183.51 | Unavailable |
| Santa Cruz, CA | $154.62 | Unavailable |
| Santa Maria, CA | $148.38 | Unavailable |
| Santa Rosa, CA | $156.27 | Unavailable |
| Stockton, CA | $139.47 | Unavailable |
| Vallejo, CA | $167.73 | Unavailable |
| Visalia, CA | $139.47 | Unavailable |
| Yuba City, CA | $139.47 | Unavailable |
How the Q4364 rate is calculated
Each of Q4364’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 · Q4364
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 Q4364
The CMS indicators that decide how Q4364 is paid alongside other services.
CMS payment indicators · Q4364
Amniotic membrane, XPL product, 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. |
Q4364 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4363Amniotic membraneHydrated Amniobur, per sq cm
- Q4363 identifies the AmnioBurr hydro membrane product; Q4364 identifies the XPL product. Match the claim to the specific product supplied.
- Q4365Wound productPer square centimeter
- Q4365 identifies a dual-layer AmnioBurr membrane product. Q4364 is the XPL product, so the product documentation determines which code applies.
- Q4366Amniotic membraneDL AmnioBUR X-Mem, per sq cm
- Q4366 identifies the dual-layer AmnioBurr X-membrane product. Do not substitute it for Q4364 when the supplied product is the XPL membrane.
Q4364 billing questions
How is Q4364 different from Q4363?
Both identify AmnioBurr membrane products, but Q4364 is the XPL product. Select the code matching the product documented and supplied; Q4363 identifies the hydro product.
What should be billed with Q4364?
CMS classifies Q4364 as an add-on code, so report it only with the applicable primary procedure. For wound treatment, the primary procedure generally describes the skin-substitute application.
How are units counted?
The code is reported per square centimeter. Document the area of product used to support the units submitted.
What does the global-period rule mean for this code?
Q4364 is paid within the associated primary procedure’s global period and is not reported on its own as a standalone service.
Does Q4364 include interpretation?
No. CMS identifies Q4364 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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