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HCPCS Q4294: Amniotic graftMedicare rate & RVUs

Reports Amnio Quad-Core amniotic wound product by square centimeter when supplied with a primary wound procedure for a skin defect.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4294 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4294

Amniotic graft

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4294 →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 Q4294 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 Q4294 covers

Q4294 identifies Amnio Quad-Core, an amniotic wound product supplied by area for use in wound treatment. Wound-care physicians, surgeons, and podiatrists may use it during treatment of skin defects such as diabetic foot ulcers or venous leg ulcers. The application procedure addresses the wound; this code identifies the product used rather than the clinical work of applying it.

Report Q4294 only with a primary procedure, using units that reflect the square centimeters represented by the product. Documentation should identify the product, wound site and size, and amount used. CMS treats the code as an add-on paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation. The code has no separate work value in the CMS physician fee schedule facts provided.

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 Q4294 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

Q4294 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

Q4294 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
Q4294 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 Q4294 rate is calculated

Each of Q4294’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 · Q4294

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 Q4294

The CMS indicators that decide how Q4294 is paid alongside other services.

CMS payment indicators · Q4294

Amniotic 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.

Q4294 compared with similar codes

Compare codes · National

4 codes, side by side

  • Q4294

    Amniotic graft0 wRVU

    $127.26

  • Q4295

    Amniotic tissue product0 wRVU

    $127.26+$0.00

  • 15271

    Skin substitute graft1.46 wRVU

    $157.99+$30.73

  • 15275

    Skin substitute1.78 wRVU

    $160.32+$33.06

How to choose

Q4295Amniotic tissue product
Q4295 identifies Amnio Tri-Core; Q4294 identifies Amnio Quad-Core. Match the claim to the product actually supplied.
15271Skin substitute graft
Q4294 reports the Amnio Quad-Core product by area. Code 15271 reports the primary application service for qualifying trunk, arm, or leg wounds.
15275Skin substitute
Q4294 identifies the product supplied. Code 15275 reports the primary application service for qualifying wounds on the head, face, neck, hand, foot, or genitalia.

Codes related to Q4294

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

Codes related to Q4294
CodeHow it relatesNational office range
Primary code
15271Skin substitute graftPrimary application procedure for a skin substitute on qualifying trunk, arm, or leg wounds.$140.17–$205.27
15272Skin substitute graftAdditional-area application procedure for qualifying trunk, arm, or leg wounds.$23.02–$32.02
15275Skin substitutePrimary application procedure for a skin substitute on qualifying head, face, neck, hand, foot, or genital wounds.$143.80–$205.40
Same family
Q4295Amniotic tissue productAmnio Tri-Core is a distinct product-specific code billed per square centimeter.$109.31–$183.51

Q4294 billing questions

How is Q4294 different from Q4295?

Q4294 identifies Amnio Quad-Core, while Q4295 identifies Amnio Tri-Core. Select the code that matches the product supplied; the names do not make the products interchangeable.

Is Q4294 reported by wound area or product amount?

The unit is per square centimeter. Document the wound site and size and the amount of Amnio Quad-Core used to support the units reported.

Can Q4294 be billed without a wound procedure?

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

Does Q4294 include the work of applying the product?

Q4294 identifies the product, not the application service. Report the applicable primary wound procedure for the application.

How does the global-period rule affect Q4294?

Payment for Q4294 is within the primary procedure’s global period; it is not treated as a separate service outside that procedure’s period.

Is interpretation included in Q4294?

CMS classifies Q4294 as technical-component-only, with interpretation covered by a separate code.

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 Q4294PPRRVU2026_Oct_nonQPP.csv, line 18,381 (RVU26D)

Open CMS sourceHow we calculate rates

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