HCPCS code Q4367: Amniotic tissue product, amniocore SL, per cm²2026 Medicare rate & RVUs in Louisiana
Reports each square centimeter of Amniocore SL amniotic tissue used to cover a wound, alongside the applicable primary wound procedure.
Medicare pays $112.62–$119.75 for Q4367 in the office in Louisiana, from Rest of Louisiana to New Orleans, LA. 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 Q4367 covers
Q4367 identifies Amniocore SL, an amniotic tissue product applied to a wound bed as a covering. It may be used by wound care clinicians or surgeons treating wounds such as diabetic foot ulcers or venous leg ulcers. The code identifies the product by brand and billed area, rather than the clinician’s evaluation of the wound or the application work itself.
Report units based on the square centimeters of product applied, and document the product, wound site, amount used, and associated procedure. CMS classifies Q4367 as an add-on code: report it only with a primary procedure, and payment falls within that procedure’s global period. CMS also classifies it as technical-component-only, with interpretation covered by a separate code. The primary application code depends on the wound site and area; for example, the applicable skin-substitute application code may be from the 15271–15278 series.
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 Q4367 pays more and less in Louisiana
| Payment locality | Office | Facility |
|---|---|---|
| New Orleans, LA | $119.75 | Unavailable |
| Rest of Louisiana | $112.62 | Unavailable |
How the Q4367 rate is calculated
Each of Q4367’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 · Q4367
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 Q4367
The CMS indicators that decide how Q4367 is paid alongside other services.
CMS payment indicators · Q4367
Amniotic tissue product, amniocore SL, per cm²
| 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. |
Q4367 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- Q4366Amniotic membraneDL AmnioBUR X-Mem, per sq cm
- Q4366 identifies DL Amnio Bur X-Mem, while Q4367 identifies Amniocore SL. Select the product-specific code that matches the material documented as applied.
- Q4368Wound matrixAmchothick, per square centimeter
- Q4368 identifies Amchothick rather than Amniocore SL. The wound site does not determine which of these product codes to report.
- 15271Skin substitute graftFirst 25 cm², trunk/limbs
- 15271 reports the primary application procedure for qualifying trunk, arm, or leg wounds; Q4367 identifies the Amniocore SL product used with a primary procedure.
- 15275Skin substituteFace and other specified sites
- 15275 reports the primary application procedure for qualifying wounds at specified other sites; Q4367 reports the product, not the application work.
Q4367 billing questions
Can Q4367 be reported by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure. Pair it with the applicable wound application procedure.
How are units determined?
Report the square centimeters of Amniocore SL applied. The record should support the product identity and the area used.
Which application code should accompany it?
Choose the primary skin-substitute application code based on wound location and area. Codes in the 15271–15278 series may apply.
Is there a separate professional interpretation component?
CMS classifies Q4367 as technical-component-only and indicates that a separate code covers interpretation.
How does Q4367 differ from Q4368?
Q4367 identifies Amniocore SL; Q4368 identifies Amchothick. Use the code matching the product actually applied, not one selected by wound location.
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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