HCPCS Q4295: Amniotic tissue productMedicare rate & RVUs in Florida
Reports Amnio Tri-Core amniotic tissue by square centimeter when supplied with a primary wound-treatment procedure that uses the product.
Medicare pays $121.66–$132.47 for Q4295 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$121.66 to $132.47
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $128.91 | Unavailable |
| Miami | $132.47 | Unavailable |
| Rest Of Florida | $121.66 | Unavailable |
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.
How the rate is built · Q4295
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 3.81Malpractice 0.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4295
The CMS indicators that decide how Q4295 is paid alongside other services.
CMS payment indicators · Q4295
Amniotic tissue product
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4295 compared with similar codes
Compare codes
Q4295 vs Q4294 vs Q4280 vs 15271: national Medicare rates
Swap in your local Medicare rate.
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.
Q4295 billing questions
Can Q4295 be reported by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
How is Q4295 different from Q4294?
Q4295 identifies Amnio Tri-Core, while Q4294 identifies Amnio Quad-Core. Report the code matching the product used.
How should the quantity be reported?
The descriptor is per square centimeter. Documentation should support the area of Amnio Tri-Core represented by the billed quantity.
Does Q4295 include the product application service?
No. Q4295 identifies the product; report the appropriate primary application procedure separately for the treated site and wound area.
How are interpretation and the technical component handled?
CMS classifies Q4295 as technical-component-only. A separate code covers interpretation.
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
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