HCPCS Q4366: Amniotic membraneMedicare rate & RVUs in Illinois
Reports each square centimeter of DL AmnioBUR X-Mem used as a wound covering during a separately reported skin-substitute application procedure.
Medicare pays $116.19–$130.69 for Q4366 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 Q4366 covers
Q4366 identifies the DL AmnioBUR X-Mem amniotic membrane product, counted by square centimeter. A wound-care physician, podiatrist, or surgeon may use it as a covering for a wound, such as a diabetic foot ulcer or venous leg ulcer, in an outpatient wound clinic or surgical setting. The product code represents the graft material, not the clinician’s work of preparing the wound or applying the graft.
Report the product only with a primary application procedure, such as the appropriate skin-substitute application code for the wound site and treated area. Document the product identity, wound location, area treated, and quantity used; report Q4366 units in square centimeters. CMS classifies Q4366 as a technical-component-only code, with interpretation covered by a separate code. Payment for this add-on is included within the primary procedure’s global period.
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 Q4366 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$116.19 to $130.69
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $127.89 | Unavailable |
| East St. Louis | $117.08 | Unavailable |
| Rest Of Illinois | $116.19 | Unavailable |
| Suburban Chicago | $130.69 | Unavailable |
How the Q4366 rate is calculated
Each of Q4366’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 · Q4366
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 Q4366
The CMS indicators that decide how Q4366 is paid alongside other services.
CMS payment indicators · Q4366
Amniotic membrane
| 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. |
Q4366 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4365Wound product
- Q4365 identifies a different AmnioBUR product. Choose between it and Q4366 by the specific product used, not simply because both are amniotic membrane grafts.
- Q4364Amniotic membrane
- Q4364 identifies another AmnioBUR product. Match the claim to the exact product name and labeling rather than treating these product codes as interchangeable.
- Q4367Amniotic tissue product
- Q4367 is a separate product code for Amniocore SL. Use Q4366 for DL AmnioBUR X-Mem, not for another amniotic membrane product.
Q4366 billing questions
How is Q4366 distinguished from other amniotic membrane codes?
Use Q4366 only when the product is specifically DL AmnioBUR X-Mem. Select a different product code when the graft’s product name or labeling identifies another product, even if it is also amniotic tissue.
Can Q4366 be billed without a wound application procedure?
No. CMS identifies it as an add-on code, so it must be reported with a primary procedure. The primary application code depends on the wound site and treated area.
How are the units reported?
Report the quantity in square centimeters. Documentation should identify the graft product and support the wound area and amount used.
Does Q4366 include the clinician’s work applying the graft?
No. Q4366 identifies the product. Report the appropriate primary application procedure for the clinician’s work; payment for Q4366 falls within that procedure’s global period.
What does technical-component-only mean for Q4366?
CMS classifies the code as technical-component-only and indicates that a separate code covers interpretation. Q4366 itself identifies the graft product.
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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