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HCPCS Q4250: Wound allograftMedicare rate & RVUs

Q4250 reports the AmnioAMP-MP amniotic membrane product, measured by square centimeter, when supplied for application to a wound.

CMS RVU26DEffective Oct 1, 2026109 payment localities70.4K Medicare services in 2024

Medicare pays $127.26 for Q4250 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4250

Wound allograft

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4250 →Billed by an NP, PA or therapist? →

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 Q4250 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 Q4250 covers

Q4250 identifies the AmnioAMP-MP amniotic membrane product by the square centimeter. It represents the product supplied for wound coverage, not the clinician’s work applying it. Wound care clinicians, surgeons, and podiatrists may use this type of membrane during treatment of wounds in office, outpatient, or surgical settings. The product code is reported with the primary procedure that applies the membrane, such as an appropriate skin substitute application service.

Report units according to the square centimeters of product supplied, supported by the product record and documentation of the wound site, dimensions, and amount used. Q4250 is an add-on code: bill it only with a primary procedure, and payment falls within that procedure’s global period. It is a technical-component-only code; a separate code covers interpretation. The application service and the product are distinct coding elements, so the application procedure must be reported separately when performed.

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 Q4250 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

Q4250 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

Q4250 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
Q4250 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 Q4250 rate is calculated

Each of Q4250’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 · Q4250

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 Q4250

The CMS indicators that decide how Q4250 is paid alongside other services.

CMS payment indicators · Q4250

Wound allograft

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.

Q4250 compared with similar codes

Compare codes · National

4 codes, side by side

  • Q4250

    Wound allograft0 wRVU

    $127.26

  • 15271

    Skin substitute graft1.46 wRVU

    $157.99+$30.73

  • 15275

    Skin substitute1.78 wRVU

    $160.32+$33.06

  • Q4247

    Amniotext patch0 wRVU

    $127.26+$0.00

How to choose

15271Skin substitute graft
15271 reports the primary application service for eligible wounds on the trunk, arms, or legs; Q4250 reports the AmnioAMP-MP product supplied with that service.
15275Skin substitute
15275 reports the primary application service for eligible wounds on the head, face, digits, or genitalia; Q4250 identifies the product, not the application work.
Q4247Amniotext patch
Q4247 identifies Amniotext patch per square centimeter, whereas Q4250 identifies AmnioAMP-MP per square centimeter. Select the product code matching the item supplied.

Codes related to Q4250

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

Codes related to Q4250
CodeHow it relatesNational office range
Primary code
15271Skin substitute graftA primary skin substitute application service for eligible wounds on the trunk, arms, or legs.$140.17–$205.27
15275Skin substituteA primary skin substitute application service for eligible wounds on the head, face, digits, or genitalia.$143.80–$205.40
Used instead
Q4239Amniotic graftA separately identified Amnio-Maxx or Lite product, also measured per square centimeter.$109.31–$183.51
Q4247Amniotext patchAmniotext patch is a distinct amniotic product code measured per square centimeter.$109.31–$183.51
Q4248Wound allograftA separately identified amniotic membrane allograft product code.$109.31–$183.51

Q4250 billing questions

Can Q4250 be billed by itself?

No. It is an add-on product code and must be billed with a primary procedure, such as an appropriate skin substitute application service.

How are units determined?

The unit of measure is one square centimeter. Document the product amount supplied and the wound dimensions that support the reported units.

Does Q4250 include the clinician’s application work?

No. Q4250 identifies the AmnioAMP-MP product; report the applicable primary procedure separately for the work of applying it.

Is interpretation included in Q4250?

No. CMS identifies Q4250 as technical-component-only, with interpretation covered by a separate code.

How does Q4250 differ from Q4247?

Q4250 identifies AmnioAMP-MP per square centimeter, while Q4247 identifies Amniotext patch per square centimeter. Report the code for the product actually supplied.

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 Q4250PPRRVU2026_Oct_nonQPP.csv, line 18,338 (RVU26D)

Open CMS sourceHow we calculate rates

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