HCPCS code Q4295: Amniotic tissue product2026 Medicare rate & RVUs

Medicare pays $127.26 for Q4295 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 Q4295 covers

Q4295 identifies Amnio Tri-Core, an amniotic tissue product used as a biologic covering in wound care. It represents the product rather than the clinician’s placement service. In outpatient wound treatment, the treating clinician applies the product to the prepared wound; the appropriate application procedure depends on the treated site and wound area.

Report Q4295 by the square centimeter and only with a primary procedure, as CMS classifies it as an add-on paid within that procedure’s global period. Documentation should identify Amnio Tri-Core and support the area represented by the reported quantity. CMS assigns no physician work RVUs and 3.81 practice-expense RVUs in both office and facility settings. CMS classifies the code as technical-component-only; 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 Q4295 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

Q4295 rates by state

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

How the Q4295 rate is calculated

Each of Q4295’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 Q4295

The CMS indicators that decide how Q4295 is paid alongside other services.

Q4295 compared with similar codes

How to choose

Q4294Amniotic graft

Q4294 identifies Amnio Quad-Core; Q4295 identifies Amnio Tri-Core. Choose according to the product documented as used.

Q4280Amniotic matrix

Q4280 identifies Xcell amnio matrix, a different product. Q4295 is specific to Amnio Tri-Core.

15271Skin substitute graft

15271 reports an application procedure for the applicable site and wound area; Q4295 reports the Amnio Tri-Core product by square centimeter.

Codes related to Q4295

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