Q4242
No office rateAmniocyte plus, per 0.5 cc
Q4242 identifies Amniocyte Plus and uses a 0.5-cc unit. Q4243 identifies AmchoMatrix and uses a square-centimeter unit.
On this page
CMS RVU26D · Effective 2026-10-01
Q4243 Wound product Medicare reimbursement rates in Alabama
Report AmchoMatrix by the square centimeter when this wound product is furnished with a primary wound-application procedure. Compare Q4243 office and facility rates across CMS payment localities in Alabama.
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 Q4243 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$111.35
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
Wound care
About Q4243: AmchoMatrix wound product by area
Report AmchoMatrix by the square centimeter when this wound product is furnished with a primary wound-application procedure.
Q4243 identifies AmchoMatrix, a wound product supplied and measured by area. It may be used in wound care when a clinician applies the product to a wound as part of a primary procedure. Wound-care clinicians, podiatrists, and surgeons may encounter it in outpatient wound clinics, offices, or hospital settings. The product code represents the material, not the clinician’s wound preparation or application service.
Report the quantity in square centimeters and pair Q4243 with the primary procedure for the wound application. The record should identify the product and document the treated wound and the amount furnished. CMS classifies Q4243 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period. It is also a technical-component-only code; a separate code covers interpretation.
CMS billing rules for Q4243
- 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.
Q4243 compared with similar codes
Office rates for Alabama, from the same CMS release.
$111.35
Q4232 identifies Corplex, while Q4243 identifies AmchoMatrix. Both are measured per square centimeter, so distinguish them by the product furnished.
$111.35
Q4247 identifies the Amniotext patch and is measured per square centimeter. Q4243 is the AmchoMatrix product; choose according to the product used.
Compare Q4243 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
$111.35
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for Q4243 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
18,332
- Code
- Q4243
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.875 | 3.3338 |
| Malpractice | 0.00 | × 0.566 | 0.0000 |
| Total RVUs | 3.3338 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$111.35
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.875 |
| Malpractice | 0 | 0.566 |
(0 × 1 + 3.81 × 0.875 + 0 × 0.566) × $33.4009 = $111.35
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
Q4243 billing questions
How is Q4243 different from Q4242?
Q4243 identifies AmchoMatrix and is measured per square centimeter. Q4242 identifies Amniocyte Plus and is measured per 0.5 cc; select the code for the product actually furnished.
Can Q4243 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure. For wound application, the primary procedure may be selected from the applicable skin-substitute application codes.
What documentation supports the units?
Document that AmchoMatrix was used, identify the treated wound, and record the amount furnished in square centimeters.
Does Q4243 include interpretation?
No. CMS classifies Q4243 as technical-component-only; a separate code covers interpretation.
How does the global-period rule affect payment?
Q4243 is paid within the global period of the primary procedure with which it is reported.
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.
18,329Q4240,,Corecyte topical only 0.5 cc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,330Q4241,,"Polycyte, topical only 0.5cc",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,331Q4242,,"Amniocyte plus, per 0.5 cc",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,332Q4243,,"Amchomatrix, per sq cm",A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,333Q4245,,"Amniotext, per cc",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,334Q4246,,"Coretext or protext, per cc",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,335Q4247,,"Amniotext patch, 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
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515