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HCPCS Q4205: Membrane graftMedicare rate & RVUs

Q4205 reports membrane graft or wrap material applied during a primary wound-care or surgical procedure, with units based on the treated area.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4205 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4205

Membrane graft

Swap in your local Medicare rate.

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4205 →

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 10 sections
  1. Medicare rate
  2. What Q4205 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What Q4205 covers

Q4205 identifies membrane material applied as a graft or wrap to cover a treated wound or operative site. It represents the product, not the clinician’s evaluation or application work. Wound-care clinicians and surgeons may report it when they use the specified material as part of wound treatment or a surgical procedure.

Report the quantity in square centimeters and document the product, treated site, area used, and related primary procedure. CMS classifies Q4205 as an add-on: it must be billed with a primary procedure, and its 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 Q4205 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$109.31 to $183.51

$109.31$146.41$183.51
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

Q4205 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$111.35Unavailable
Alaska*$135.53Unavailable
Arizona$123.31Unavailable
Arkansas$109.31Unavailable
Atlanta$129.29Unavailable
Austin$134.64Unavailable
Bakersfield$139.47Unavailable
Baltimore/Surr. Cntys$136.55Unavailable
Beaumont$115.80Unavailable
Brazoria$126.11Unavailable

Q4205 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
Q4205 office rate range by state
State / territoryOffice rate rangeLocalities
AK$135.531
AL$111.351
AR$109.311
AZ$123.311
CA$139.47–$183.5129
CO$135.401
CT$137.061
DC$149.911
DE$125.731
FL$121.66–$132.473
GA$113.51–$129.292
GU$144.691
HI$144.691
IA$116.441
ID$117.081
IL$116.19–$130.694
IN$117.971
KS$115.041
KY$113.131
LA$112.62–$119.752
MA$134.00–$151.952
MD$128.78–$149.913
ME$117.08–$126.112
MI$116.19–$122.802
MN$130.951
MO$109.70–$121.153
MS$109.571
MT$127.261
NC$118.731
ND$127.261
NE$117.461
NH$132.471
NJ$138.97–$147.622
NM$116.701
NV$127.381
NY$120.89–$151.315
OH$116.191
OK$113.641
OR$126.75–$141.382
PA$116.82–$132.472
PR$128.661
RI$131.461
SC$117.591
SD$127.261
TN$115.681
TX$115.80–$134.648
UT$119.621
VA$125.09–$149.912
VI$128.661
VT$125.981
WA$134.00–$156.142
WI$121.911
WV$110.591
WY$127.261

How the Q4205 rate is calculated

Each of Q4205’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 · Q4205

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 3.81Malpractice 0.00

3.8100 adjusted RVUs×$33.4009 conversion factor=$127.26

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for Q4205

The CMS indicators that decide how Q4205 is paid alongside other services.

CMS payment indicators · Q4205

Membrane graft

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical3Technical component only.

Q4205 compared with similar codes

Compare codes

Q4205 vs Q4204 vs Q4211 vs Q4206: national Medicare rates

Swap in your local Medicare rate.

  • Q4205
    Membrane graft · 0 wRVU
    $127.26
  • Q4204
    Xwrap · 0 wRVU
    $127.26+$0.00
  • Q4211
    Wound product · 0 wRVU
    $127.26+$0.00
  • Q4206
    · 0 wRVU
    —

How to choose

Q4204Xwrap
Q4204 identifies Xwrap. Choose the code matching the product applied rather than treating the two product codes as interchangeable.
Q4211Wound product
Q4211 identifies amnion bio or axobio; Q4205 identifies the membrane graft or wrap product. The product used determines the code.
Q4206Fluid flow or fluid gf 1 cc
Q4206 describes a different product reported by cubic centimeter. Q4205 is the membrane product measured by square centimeter.

Codes related to Q4205

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to Q4205
CodeHow it relatesNational office range
Used instead
Q4204XwrapUse the product-specific code for Xwrap when that material, rather than Q4205, is applied.$109.31–$183.51
Q4203Skin substituteDerma-gide has its own product-specific code and is measured by square centimeter.$109.31–$183.51
Q4208Wound productNovafix is separately identified and reported by square centimeter when that product is used.$109.31–$183.51
Q4211Wound productAmnion bio or axobio has a separate product-specific code measured by square centimeter.$109.31–$183.51

Q4205 billing questions

Can Q4205 be billed by itself?

No. CMS identifies it as an add-on that must be billed with a primary procedure.

How should units be counted?

Count the membrane material in square centimeters. Document the area used at the treated site.

What documentation supports Q4205?

Record the product used, the treated site, the area applied, and the primary procedure performed.

How does the global period affect payment?

Payment for Q4205 falls within the global period of the primary procedure reported with it.

Does Q4205 include interpretation?

No. CMS classifies it 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
RVUs for Q4205PPRRVU2026_Oct_nonQPP.csv, line 18,297 (RVU26D)

Open CMS sourceHow we calculate rates

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