$144.69
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 in Guam
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 in Guam.
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 in Guam?
Guam 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
$144.69
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 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 rates for Guam, from the same CMS release.
$144.69
Q4402 identifies Xwrap 2.0, not Xwrap Fenestra. Choose according to the specific product supplied.
$144.69
Q4403 identifies Xwrap Dual Plus. It is not interchangeable with Q4406 solely because both are Xwrap products billed by area.
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.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$144.69
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 Q4406 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
18,491
- Code
- Q4406
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 1.137 | 4.3320 |
| Malpractice | 0.00 | × 0.579 | 0.0000 |
| Total RVUs | 4.3320 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$144.69
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 1.137 |
| Malpractice | 0 | 0.579 |
(0 × 1 + 3.81 × 1.137 + 0 × 0.579) × $33.4009 = $144.69
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.
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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014