$117.97
Q4294 identifies Amnio Quad-Core; Q4295 identifies Amnio Tri-Core. Choose according to the product documented as used.
On this page
CMS RVU26D · Effective 2026-10-01
Q4295 Amniotic tissue product Medicare reimbursement rates in Indiana
Reports Amnio Tri-Core amniotic tissue by square centimeter when supplied with a primary wound-treatment procedure that uses the product. Compare Q4295 office and facility rates across CMS payment localities in Indiana.
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 Q4295 in Indiana?
Indiana 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
$117.97
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Skin substitute product
About Q4295: Amnio Tri-Core wound product
Reports Amnio Tri-Core amniotic tissue by square centimeter when supplied with a primary wound-treatment procedure that uses the product.
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.
CMS billing rules for Q4295
- 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.
Q4295 compared with similar codes
Office rates for Indiana, from the same CMS release.
$117.97
Q4280 identifies Xcell amnio matrix, a different product. Q4295 is specific to Amnio Tri-Core.
$146.92
15271 reports an application procedure for the applicable site and wound area; Q4295 reports the Amnio Tri-Core product by square centimeter.
Compare Q4295 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
Indiana →
Office / nonfacility
$117.97
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 Q4295 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
18,382
- Code
- Q4295
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.927 | 3.5319 |
| Malpractice | 0.00 | × 0.486 | 0.0000 |
| Total RVUs | 3.5319 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$117.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.927 |
| Malpractice | 0 | 0.486 |
(0 × 1 + 3.81 × 0.927 + 0 × 0.486) × $33.4009 = $117.97
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.
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 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.
18,379Q4292,,"Lamellas, 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
18,380Q4293,,"Acesso dl, 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
18,381Q4294,,"Amnio quad-core, 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
18,382Q4295,,"Amnio tri-core, 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
18,383Q4296,,"Rebound matrix, 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
18,384Q4297,,"Emerge matrix, 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
18,385Q4298,,"Amniocore pro, 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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915