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HCPCS Q4436: Skin substituteMedicare rate & RVUs

Reports Renati AC membrane supplied by area for wound coverage, alongside the applicable skin-substitute application procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $127.26 for Q4436 nationally in the office. Local office rates run $109.31–$183.51.

Medicare rate · Q4436

Skin substitute

Swap in your local Medicare rate.

Work RVUs
0
Total RVUs
3.81
Global days
ZZZ

National rate · 2026

$127.26

Office setting, before claim adjustments.

See every locality for Q4436 → · 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 Q4436 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 Q4436 covers

Q4436 identifies Renati AC membrane supplied for wound coverage, with the product quantity reported by square centimeter. A physician or other qualified practitioner may apply the membrane to a prepared wound during outpatient wound care or a surgical procedure. The product code identifies the material supplied; it does not identify the wound site or the application technique.

Report Q4436 only with the primary procedure for applying the skin substitute, and base the units on the area of membrane applied. The record should identify the product and document the treated wound and amount used. CMS treats this as an add-on code paid within the primary procedure's global period, so it is not a standalone service. CMS also classifies it as technical-component-only; a separate code represents 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 Q4436 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

Q4436 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

Q4436 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
Q4436 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 Q4436 rate is calculated

Each of Q4436’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 · Q4436

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 3.81Malpractice 0.00

3.8100 adjusted RVUs×$33.4009 conversion factor=$127.26

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for Q4436

The CMS indicators that decide how Q4436 is paid alongside other services.

CMS payment indicators · Q4436

Skin substitute

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.

Q4436 compared with similar codes

Compare codes

Q4436 vs Q4435 vs Q4437 vs 15271: national Medicare rates

Swap in your local Medicare rate.

  • Q4436
    Skin substitute · 0 wRVU
    $127.26
  • Q4435
    Renati membrane · 0 wRVU
    $127.26+$0.00
  • Q4437
    Skin substitute · 0 wRVU
    $127.26+$0.00
  • 15271
    Skin substitute graft · 1.46 wRVU
    $157.99+$30.73

How to choose

Q4435Renati membrane
Q4435 identifies Renati membrane, while Q4436 identifies Renati AC membrane. Choose according to the specific product used, not the wound location.
Q4437Skin substitute
Q4437 identifies Revival AC rather than Renati AC membrane. The product code follows the material supplied.
15271Skin substitute graft
15271 reports the application procedure for qualifying trunk, arm, or leg wounds; Q4436 reports the Renati AC membrane product by area.

Codes related to Q4436

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

Codes related to Q4436
CodeHow it relatesNational office range
Often billed with
15271Skin substitute graftApplication procedure for skin substitute on qualifying trunk, arm, or leg wounds.$140.17–$205.27
15275Skin substituteApplication procedure for skin substitute on qualifying head, neck, hand, foot, or genital wounds.$143.80–$205.40
Used instead
Q4435Renati membraneIdentifies Renati membrane; report the product code matching the material supplied.$109.31–$183.51
Q4437Skin substituteIdentifies a different AC skin-substitute product; select based on the product supplied.$109.31–$183.51

Q4436 billing questions

Can Q4436 be billed by itself?

No. CMS identifies Q4436 as an add-on that must be reported with a primary procedure and is paid within that procedure's global period.

How should the units be determined?

Report the square centimeters of Renati AC membrane applied. Document the treated wound and the amount of product used.

Does Q4436 identify the wound application procedure?

No. Q4436 identifies the Renati AC membrane product. Select the application procedure separately according to the wound site and applicable procedure criteria.

Is interpretation included in Q4436?

No. CMS classifies Q4436 as technical-component-only, with interpretation represented by a separate code.

Can Q4436 be used for another Renati membrane product?

Use Q4436 when the supplied product is Renati AC membrane. A different Renati product may have its own HCPCS code, such as Q4435.

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 Q4436PPRRVU2026_Oct_nonQPP.csv, line 18,519 (RVU26D)

Open CMS sourceHow we calculate rates

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