$109.31–$183.51
Use Q4405 for Xwrap Fenestra Plus. Q4406 identifies Xwrap Fenestra; the product name on the documentation determines the code.
On this page
CMS RVU26D · Effective 2026-10-01
Q4406 Skin substitute Medicare reimbursement rates
Reports Xwrap Fenestra by square centimeter when this wound-covering product is used with a separately coded primary wound procedure. Compare Q4406 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for Q4406?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$109.31–$183.51
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
A spread of $74.20 per service.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where Q4406 pays more and less
109 payment localities
$109.31 to $183.51
Wound care supply
About Q4406: Xwrap Fenestra wound covering by area
Reports Xwrap Fenestra by square centimeter when this wound-covering product is used with a separately coded primary wound procedure.
Q4406 identifies the Xwrap Fenestra product supplied for wound coverage, measured by area in square centimeters. It is used in wound-care treatment when the clinician applies this specific product to a wound. Wound-care physicians and surgeons may use it in outpatient or facility settings; the code identifies the product rather than the wound assessment or application service.
Report Q4406 with the applicable primary procedure for applying the product, selected according to the wound’s site and treated area. The claim should identify Xwrap Fenestra and support the quantity billed with documentation of the product used and wound area treated. CMS classifies Q4406 as an add-on code, paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation.
CMS billing rules for Q4406
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU3.81 · 100%
- Malpractice RVU0.00 · 0%
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.
Q4406 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$109.31–$183.51
Q4402 identifies Xwrap 2.0, not Xwrap Fenestra. Choose according to the specific product supplied.
$109.31–$183.51
Q4403 identifies Xwrap Dual Plus. It is not interchangeable with Q4406 solely because both are Xwrap products billed by area.
See how rates vary across the country
Q4406 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $135.53 | 1 |
| AL | $111.35 | 1 |
| AR | $109.31 | 1 |
| AZ | $123.31 | 1 |
| CA | $139.47–$183.51 | 29 |
| CO | $135.40 | 1 |
| CT | $137.06 | 1 |
| DC | $149.91 | 1 |
| DE | $125.73 | 1 |
| FL | $121.66–$132.47 | 3 |
| GA | $113.51–$129.29 | 2 |
| GU | $144.69 | 1 |
| HI | $144.69 | 1 |
| IA | $116.44 | 1 |
| ID | $117.08 | 1 |
| IL | $116.19–$130.69 | 4 |
| IN | $117.97 | 1 |
| KS | $115.04 | 1 |
| KY | $113.13 | 1 |
| LA | $112.62–$119.75 | 2 |
| MA | $134.00–$151.95 | 2 |
| MD | $128.78–$149.91 | 3 |
| ME | $117.08–$126.11 | 2 |
| MI | $116.19–$122.80 | 2 |
| MN | $130.95 | 1 |
| MO | $109.70–$121.15 | 3 |
| MS | $109.57 | 1 |
| MT | $127.26 | 1 |
| NC | $118.73 | 1 |
| ND | $127.26 | 1 |
| NE | $117.46 | 1 |
| NH | $132.47 | 1 |
| NJ | $138.97–$147.62 | 2 |
| NM | $116.70 | 1 |
| NV | $127.38 | 1 |
| NY | $120.89–$151.31 | 5 |
| OH | $116.19 | 1 |
| OK | $113.64 | 1 |
| OR | $126.75–$141.38 | 2 |
| PA | $116.82–$132.47 | 2 |
| PR | $128.66 | 1 |
| RI | $131.46 | 1 |
| SC | $117.59 | 1 |
| SD | $127.26 | 1 |
| TN | $115.68 | 1 |
| TX | $115.80–$134.64 | 8 |
| UT | $119.62 | 1 |
| VA | $125.09–$149.91 | 2 |
| VI | $128.66 | 1 |
| VT | $125.98 | 1 |
| WA | $134.00–$156.14 | 2 |
| WI | $121.91 | 1 |
| WV | $110.59 | 1 |
| WY | $127.26 | 1 |
Compare Q4406 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $111.35 | Facility Unavailable |
| Alaska* | Office $135.53 | Facility Unavailable |
| Arizona | Office $123.31 | Facility Unavailable |
| Arkansas | Office $109.31 | Facility Unavailable |
| Atlanta | Office $129.29 | Facility Unavailable |
| Austin | Office $134.64 | Facility Unavailable |
| Bakersfield | Office $139.47 | Facility Unavailable |
| Baltimore/Surr. Cntys | Office $136.55 | Facility Unavailable |
| Beaumont | Office $115.80 | Facility Unavailable |
| Brazoria | Office $126.11 | Facility Unavailable |
| Chicago | Office $127.89 | Facility Unavailable |
| Chico | Office $139.47 | Facility Unavailable |
| Colorado | Office $135.40 | Facility Unavailable |
| Connecticut | Office $137.06 | Facility Unavailable |
| Dallas | Office $126.75 | Facility Unavailable |
| Dc + Md/Va Suburbs | Office $149.91 | Facility Unavailable |
| Delaware | Office $125.73 | Facility Unavailable |
| Detroit | Office $122.80 | Facility Unavailable |
| East St. Louis | Office $117.08 | Facility Unavailable |
| El Centro | Office $139.47 | Facility Unavailable |
| Fort Lauderdale | Office $128.91 | Facility Unavailable |
| Fort Worth | Office $125.48 | Facility Unavailable |
| Fresno | Office $139.47 | Facility Unavailable |
| Galveston | Office $126.37 | Facility Unavailable |
| Hanford-Corcoran | Office $139.47 | Facility Unavailable |
| Hawaii, Guam | Office $144.69 | Facility Unavailable |
| Houston | Office $126.37 | Facility Unavailable |
| Idaho | Office $117.08 | Facility Unavailable |
| Indiana | Office $117.97 | Facility Unavailable |
| Iowa | Office $116.44 | Facility Unavailable |
| Kansas | Office $115.04 | Facility Unavailable |
| Kentucky | Office $113.13 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $150.55 | Facility Unavailable |
| Madera | Office $139.47 | Facility Unavailable |
| Manhattan | Office $147.87 | Facility Unavailable |
| Merced | Office $139.47 | Facility Unavailable |
| Metropolitan Boston | Office $151.95 | Facility Unavailable |
| Metropolitan Kansas City | Office $119.49 | Facility Unavailable |
| Metropolitan Philadelphia | Office $132.47 | Facility Unavailable |
| Metropolitan St. Louis | Office $121.15 | Facility Unavailable |
| Miami | Office $132.47 | Facility Unavailable |
| Minnesota | Office $130.95 | Facility Unavailable |
| Mississippi | Office $109.57 | Facility Unavailable |
| Modesto | Office $139.47 | Facility Unavailable |
| Montana** | Office $127.26 | Facility Unavailable |
| Napa | Office $167.73 | Facility Unavailable |
| Nebraska | Office $117.46 | Facility Unavailable |
| Nevada** | Office $127.38 | Facility Unavailable |
| New Hampshire | Office $132.47 | Facility Unavailable |
| New Mexico | Office $116.70 | Facility Unavailable |
| New Orleans | Office $119.75 | Facility Unavailable |
| North Carolina | Office $118.73 | Facility Unavailable |
| North Dakota** | Office $127.26 | Facility Unavailable |
| Northern Nj | Office $147.62 | Facility Unavailable |
| Nyc Suburbs/Long Island | Office $151.31 | Facility Unavailable |
| Ohio | Office $116.19 | Facility Unavailable |
| Oklahoma | Office $113.64 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $150.42 | Facility Unavailable |
| Portland | Office $141.38 | Facility Unavailable |
| Poughkpsie/N Nyc Suburbs | Office $139.35 | Facility Unavailable |
| Puerto Rico | Office $128.66 | Facility Unavailable |
| Queens | Office $150.42 | Facility Unavailable |
| Redding | Office $139.47 | Facility Unavailable |
| Rest Of California | Office $139.47 | Facility Unavailable |
| Rest Of Florida | Office $121.66 | Facility Unavailable |
| Rest Of Georgia | Office $113.51 | Facility Unavailable |
| Rest Of Illinois | Office $116.19 | Facility Unavailable |
| Rest Of Louisiana | Office $112.62 | Facility Unavailable |
| Rest Of Maine | Office $117.08 | Facility Unavailable |
| Rest Of Maryland | Office $128.78 | Facility Unavailable |
| Rest Of Massachusetts | Office $134.00 | Facility Unavailable |
| Rest Of Michigan | Office $116.19 | Facility Unavailable |
| Rest Of Missouri | Office $109.70 | Facility Unavailable |
| Rest Of New Jersey | Office $138.97 | Facility Unavailable |
| Rest Of New York | Office $120.89 | Facility Unavailable |
| Rest Of Oregon | Office $126.75 | Facility Unavailable |
| Rest Of Pennsylvania | Office $116.82 | Facility Unavailable |
| Rest Of Texas | Office $120.77 | Facility Unavailable |
| Rest Of Washington | Office $134.00 | Facility Unavailable |
| Rhode Island | Office $131.46 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $139.47 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $148.00 | Facility Unavailable |
| Salinas | Office $147.49 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $152.20 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $179.43 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $179.43 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $183.51 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $183.51 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $144.95 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $154.62 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $148.38 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $156.27 | Facility Unavailable |
| Seattle (King Cnty) | Office $156.14 | Facility Unavailable |
| South Carolina | Office $117.59 | Facility Unavailable |
| South Dakota** | Office $127.26 | Facility Unavailable |
| Southern Maine | Office $126.11 | Facility Unavailable |
| Stockton | Office $139.47 | Facility Unavailable |
| Suburban Chicago | Office $130.69 | Facility Unavailable |
| Tennessee | Office $115.68 | Facility Unavailable |
| Utah | Office $119.62 | Facility Unavailable |
| Vallejo | Office $167.73 | Facility Unavailable |
| Vermont | Office $125.98 | Facility Unavailable |
| Virgin Islands | Office $128.66 | Facility Unavailable |
| Virginia | Office $125.09 | Facility Unavailable |
| Visalia | Office $139.47 | Facility Unavailable |
| West Virginia | Office $110.59 | Facility Unavailable |
| Wisconsin | Office $121.91 | Facility Unavailable |
| Wyoming** | Office $127.26 | Facility Unavailable |
| Yuba City | Office $139.47 | Facility Unavailable |
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Q4406 billing questions
What distinguishes Q4406 from Q4405?
Q4406 identifies Xwrap Fenestra, while Q4405 identifies Xwrap Fenestra Plus. Select the code matching the product used, not simply the wound site.
Can Q4406 be reported by itself?
No. CMS identifies Q4406 as an add-on code that must be billed with a primary procedure for the wound service.
How is the quantity determined?
The descriptor is per square centimeter. Document the wound area treated and the amount of Xwrap Fenestra used to support the units reported.
Does Q4406 include interpretation?
No. CMS classifies it as technical-component-only, with a separate code covering interpretation.
What documentation supports Q4406?
Record the product identity, wound site and area treated, and the quantity of Xwrap Fenestra used, along with the primary application procedure.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
18,488Q4403,,Xwrap dual plus per sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,489Q4404,,Xwrap hydro plus per sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,490Q4405,,Xwrap fenestra plus sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,491Q4406,,Xwrap fenestra per sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,492Q4407,,Xwrap tribus per sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,493Q4408,,Xwrap hydro per sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
18,494Q4409,,Amniomatrixf3x per sq cm,A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00