HCPCS Q4291: Wound productMedicare rate & RVUs

Medicare pays $127.26 for Q4291 nationally in the office. Local office rates run $109.31–$183.51.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What Q4291 covers

Q4291 identifies Lamellas XT wound product supplied for wound coverage, measured by area. It represents the product, not the clinician’s work to prepare or apply it. It may be reported in outpatient wound clinics, hospital outpatient departments, or other settings where a clinician performs a related wound procedure. The clinical record should identify the wound treated, the product used, and the square-centimeter quantity supported by the service.

CMS classifies Q4291 as an add-on code, so report it only with a primary procedure; its payment falls within that procedure’s global period. The code is technical-component-only, with interpretation covered by a separate code. Select Q4291 when the product furnished is Lamellas XT, rather than another wound product with its own HCPCS code. Keep the product quantity distinct from the primary procedure’s application or treatment service, and ensure the documentation supports both the primary service and the area reported.

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 Q4291 pays more and less

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

109 of 109 payment localities

Q4291 rates by state

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

How the Q4291 rate is calculated

Each of Q4291’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.

Payment rules and modifiers for Q4291

The CMS indicators that decide how Q4291 is paid alongside other services.

Q4291 compared with similar codes

How to choose

Q4292Wound matrix

Q4292 identifies Lamellas, while Q4291 identifies Lamellas XT. Choose according to the product actually furnished, not simply because both are billed by square centimeter.

15271Skin substitute graft

Q4291 reports the Lamellas XT product quantity; 15271 reports a primary wound application service when its site and area criteria are met. The product code is not a substitute for the procedure code.

Q4290Membrane wrap

Q4290 identifies Membrane Wrap Hydr, a different product. Use Q4291 only when the material furnished is Lamellas XT.

Codes related to Q4291

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

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

Open CMS sourceHow we calculate rates