HCPCS code Q4364: Amniotic membrane, XPL product, per square centimeter2026 Medicare rate & RVUs in Virginia
Reports the AmnioBurrx XPL amniotic membrane product by square centimeter when supplied for application to a wound during a primary procedure.
In Virginia, Medicare pays $125.09 for Q4364 in the office.
Check a contract rate as a % of Medicare · Q4364 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Virginia compares for Q4364
Across 109 of 109 payment localities, the office rate for Q4364 runs from $109.31 in Arkansas to $183.51 in Santa Clara County, CA. Virginia pays $125.09. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$125.09
- Los Angeles, CA · California$150.55+$25.46
- Washington, DC area · District of Columbia$149.91+$24.82
- Miami, FL · Florida$132.47+$7.38
- Chicago, IL · Illinois$127.89+$2.80
- Manhattan, NY · New York$147.87+$22.78
- Alaska · Alaska$135.53+$10.44
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $111.35 | — |
| ArkansasArkansas | $109.31 | — |
| ArizonaArizona | $123.31 | — |
| Bakersfield, CACalifornia | $139.47 | — |
| Chico, CACalifornia | $139.47 | — |
| El Centro, CACalifornia | $139.47 | — |
| Fresno, CACalifornia | $139.47 | — |
| Hanford, CACalifornia | $139.47 | — |
| Madera, CACalifornia | $139.47 | — |
| Merced, CACalifornia | $139.47 | — |
| Modesto, CACalifornia | $139.47 | — |
| Napa, CACalifornia | $167.73 | — |
| Oxnard, CACalifornia | $150.42 | — |
| Redding, CACalifornia | $139.47 | — |
| Rest of CaliforniaCalifornia | $139.47 | — |
| Riverside, CACalifornia | $139.47 | — |
| Sacramento, CACalifornia | $148.00 | — |
| Salinas, CACalifornia | $147.49 | — |
| San Diego, CACalifornia | $152.20 | — |
| Marin County, CACalifornia | $179.43 | — |
| San Francisco, CACalifornia | $179.43 | — |
| San Benito County, CACalifornia | $183.51 | — |
| Santa Clara County, CACalifornia | $183.51 | — |
| San Luis Obispo, CACalifornia | $144.95 | — |
| Santa Cruz, CACalifornia | $154.62 | — |
| Santa Maria, CACalifornia | $148.38 | — |
| Santa Rosa, CACalifornia | $156.27 | — |
| Stockton, CACalifornia | $139.47 | — |
| Vallejo, CACalifornia | $167.73 | — |
| Visalia, CACalifornia | $139.47 | — |
| Yuba City, CACalifornia | $139.47 | — |
| ColoradoColorado | $135.40 | — |
| ConnecticutConnecticut | $137.06 | — |
| DelawareDelaware | $125.73 | — |
| Fort Lauderdale, FLFlorida | $128.91 | — |
| Rest of FloridaFlorida | $121.66 | — |
| Atlanta, GAGeorgia | $129.29 | — |
| Rest of GeorgiaGeorgia | $113.51 | — |
| Hawaii, Guam, HIHawaii | $144.69 | — |
| IowaIowa | $116.44 | — |
| IdahoIdaho | $117.08 | — |
| East St. Louis, ILIllinois | $117.08 | — |
| Rest of IllinoisIllinois | $116.19 | — |
| Suburban Chicago, ILIllinois | $130.69 | — |
| IndianaIndiana | $117.97 | — |
| KansasKansas | $115.04 | — |
| KentuckyKentucky | $113.13 | — |
| New Orleans, LALouisiana | $119.75 | — |
| Rest of LouisianaLouisiana | $112.62 | — |
| Metropolitan Boston, MAMassachusetts | $151.95 | — |
| Rest of MassachusettsMassachusetts | $134.00 | — |
| Baltimore area, MDMaryland | $136.55 | — |
| Rest of MarylandMaryland | $128.78 | — |
| Rest of MaineMaine | $117.08 | — |
| Southern Maine, MEMaine | $126.11 | — |
| Detroit, MIMichigan | $122.80 | — |
| Rest of MichiganMichigan | $116.19 | — |
| MinnesotaMinnesota | $130.95 | — |
| Metropolitan Kansas City, MOMissouri | $119.49 | — |
| Metropolitan St. Louis, MOMissouri | $121.15 | — |
| Rest of MissouriMissouri | $109.70 | — |
| MississippiMississippi | $109.57 | — |
| MontanaMontana | $127.26 | — |
| North CarolinaNorth Carolina | $118.73 | — |
| North DakotaNorth Dakota | $127.26 | — |
| NebraskaNebraska | $117.46 | — |
| New HampshireNew Hampshire | $132.47 | — |
| Northern New JerseyNew Jersey | $147.62 | — |
| Rest of New JerseyNew Jersey | $138.97 | — |
| New MexicoNew Mexico | $116.70 | — |
| NevadaNevada | $127.38 | — |
| NYC suburbs and Long Island, NYNew York | $151.31 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $139.35 | — |
| Queens, NYNew York | $150.42 | — |
| Rest of New YorkNew York | $120.89 | — |
| OhioOhio | $116.19 | — |
| OklahomaOklahoma | $113.64 | — |
| Portland, OROregon | $141.38 | — |
| Rest of OregonOregon | $126.75 | — |
| Metropolitan Philadelphia, PAPennsylvania | $132.47 | — |
| Rest of PennsylvaniaPennsylvania | $116.82 | — |
| Puerto RicoPuerto Rico | $128.66 | — |
| Rhode IslandRhode Island | $131.46 | — |
| South CarolinaSouth Carolina | $117.59 | — |
| South DakotaSouth Dakota | $127.26 | — |
| TennesseeTennessee | $115.68 | — |
| Austin, TXTexas | $134.64 | — |
| Beaumont, TXTexas | $115.80 | — |
| Brazoria, TXTexas | $126.11 | — |
| Dallas, TXTexas | $126.75 | — |
| Fort Worth, TXTexas | $125.48 | — |
| Galveston, TXTexas | $126.37 | — |
| Houston, TXTexas | $126.37 | — |
| Rest of TexasTexas | $120.77 | — |
| UtahUtah | $119.62 | — |
| Virgin Islands, VIUnited States Virgin Islands | $128.66 | — |
| VermontVermont | $125.98 | — |
| Rest of WashingtonWashington | $134.00 | — |
| King County, WAWashington | $156.14 | — |
| WisconsinWisconsin | $121.91 | — |
| West VirginiaWest Virginia | $110.59 | — |
| WyomingWyoming | $127.26 | — |
Q4364 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$109.31
$161.49
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $135.53 | 1 |
| AL | $111.35 | 1 |
| AR | $109.31 | 1 |
| AZ | $123.31 | 1 |
| CA | $139.47–$183.51 | 29 |
| CO | $135.40 | 1 |
| CT | $137.06 | 1 |
| DC | $149.91 | 1 |
| DE | $125.73 | 1 |
| FL | $121.66–$132.47 | 3 |
| GA | $113.51–$129.29 | 2 |
| GU | $144.69 | 1 |
| HI | $144.69 | 1 |
| IA | $116.44 | 1 |
| ID | $117.08 | 1 |
| IL | $116.19–$130.69 | 4 |
| IN | $117.97 | 1 |
| KS | $115.04 | 1 |
| KY | $113.13 | 1 |
| LA | $112.62–$119.75 | 2 |
| MA | $134.00–$151.95 | 2 |
| MD | $128.78–$149.91 | 3 |
| ME | $117.08–$126.11 | 2 |
| MI | $116.19–$122.80 | 2 |
| MN | $130.95 | 1 |
| MO | $109.70–$121.15 | 3 |
| MS | $109.57 | 1 |
| MT | $127.26 | 1 |
| NC | $118.73 | 1 |
| ND | $127.26 | 1 |
| NE | $117.46 | 1 |
| NH | $132.47 | 1 |
| NJ | $138.97–$147.62 | 2 |
| NM | $116.70 | 1 |
| NV | $127.38 | 1 |
| NY | $120.89–$151.31 | 5 |
| OH | $116.19 | 1 |
| OK | $113.64 | 1 |
| OR | $126.75–$141.38 | 2 |
| PA | $116.82–$132.47 | 2 |
| PR | $128.66 | 1 |
| RI | $131.46 | 1 |
| SC | $117.59 | 1 |
| SD | $127.26 | 1 |
| TN | $115.68 | 1 |
| TX | $115.80–$134.64 | 8 |
| UT | $119.62 | 1 |
| VA | $125.09–$149.91 | 2 |
| VI | $128.66 | 1 |
| VT | $125.98 | 1 |
| WA | $134.00–$156.14 | 2 |
| WI | $121.91 | 1 |
| WV | $110.59 | 1 |
| WY | $127.26 | 1 |
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.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
18,451
- Code
- Q4364
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.983 | 3.7452 |
| Malpractice | 0.00 | × 0.706 | 0.0000 |
| Total RVUs | 3.7452 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$125.09
Office: (0 × 1 + 3.81 × 0.983 + 0 × 0.706) × $33.4009 = $125.09
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. |
How Q4364 has changed in Virginia
Q4364 · Office / nonfacility
$125.09
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
No ratechanged to$125.09
Held through RVU26B, RVU26C, RVU26D.
April 1, 2025
RVU25B
No ratechanged toNo rate
Held through RVU25C, RVU25D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $125.09 | Not available in this setting | RVU26D |
| 2026-07-01 | $125.09 | Not available in this setting | RVU26C |
| 2026-04-01 | $125.09 | Not available in this setting | RVU26B |
| 2026-01-01 | $125.09 | Not available in this setting | RVU26A |
| 2025-10-01 | Separate payment rules apply | Separate payment rules apply | RVU25D |
| 2025-07-01 | Separate payment rules apply | Separate payment rules apply | RVU25C |
| 2025-04-01 | Separate payment rules apply | Separate payment rules apply | RVU25B |
| 2025-01-01 | Not in this release | Not in this release | RVU25A |
| 2024-10-01 | Not in this release | Not in this release | RVU24D |
| 2024-07-01 | Not in this release | Not in this release | RVU24C |
| 2024-04-01 | Not in this release | Not in this release | RVU24B |
| 2024-03-09 | Not in this release | Not in this release | RVU24AR |
| 2024-01-01 | Not in this release | Not in this release | RVU24A |
| 2023-10-01 | Not in this release | Not in this release | RVU23D |
| 2023-07-01 | Not in this release | Not in this release | RVU23C |
| 2023-04-01 | Not in this release | Not in this release | RVU23B |
| 2023-01-01 | Not in this release | Not in this release | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
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
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put Q4364 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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