HCPCS Q4291: Wound productMedicare rate & RVUs in Guam
Q4291 reports the area of Lamellas XT wound product furnished with a primary procedure, billed by square centimeter rather than as the application service.
Medicare pays $144.69 for Q4291 in the office in Guam (Hawaii, Guam). 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 Q4291 covers
Q4291 identifies Lamellas XT wound product supplied for wound coverage, measured by area. It represents the product, not the clinician’s work to prepare or apply it. It may be reported in outpatient wound clinics, hospital outpatient departments, or other settings where a clinician performs a related wound procedure. The clinical record should identify the wound treated, the product used, and the square-centimeter quantity supported by the service.
CMS classifies Q4291 as an add-on code, so report it only with a primary procedure; its payment falls within that procedure’s global period. The code is technical-component-only, with interpretation covered by a separate code. Select Q4291 when the product furnished is Lamellas XT, rather than another wound product with its own HCPCS code. Keep the product quantity distinct from the primary procedure’s application or treatment service, and ensure the documentation supports both the primary service and the area reported.
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.
Q4291 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $144.69 | Unavailable |
How the Q4291 rate is calculated
Each of Q4291’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 · Q4291
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense3.81
3.81 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
3.8100
Conversion factor
$33.4009
Medicare rate
$127.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4291
The CMS indicators that decide how Q4291 is paid alongside other services.
CMS payment indicators · Q4291
Wound 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. |
Q4291 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4292Wound matrix
- Q4292 identifies Lamellas, while Q4291 identifies Lamellas XT. Choose according to the product actually furnished, not simply because both are billed by square centimeter.
- 15271Skin substitute graft
- Q4291 reports the Lamellas XT product quantity; 15271 reports a primary wound application service when its site and area criteria are met. The product code is not a substitute for the procedure code.
- Q4290Membrane wrap
- Q4290 identifies Membrane Wrap Hydr, a different product. Use Q4291 only when the material furnished is Lamellas XT.
Q4291 billing questions
When should I use Q4291 instead of Q4292?
Use Q4291 for Lamellas XT. Q4292 identifies Lamellas; the product actually furnished determines which code to report.
Can Q4291 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure, and its payment is within that procedure’s global period.
Does Q4291 include the application service?
No. Q4291 reports the Lamellas XT product by area. Report the primary procedure separately when performed and supported by the record.
How should the quantity be documented?
Document the wound treated, the Lamellas XT product used, and the square-centimeter quantity supported by the service.
Is interpretation included in Q4291?
No. CMS classifies Q4291 as technical-component-only; a separate code covers interpretation.
Does CMS specify a modifier for Q4291?
The CMS facts provided establish add-on and component status, but no Q4291-specific modifier rule. The documentation should support the product quantity and the paired primary service.
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
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