$145.07
Q4204 identifies the Xwrap product by area; 15271 reports application of a skin substitute at qualifying trunk, arm, or leg sites.
On this page
CMS RVU26D · Effective 2026-10-01
Q4204 Xwrap Medicare reimbursement rates in Iowa
Report Q4204 for each square centimeter of Xwrap furnished for wound treatment, together with the primary procedure that applies the product. Compare Q4204 office and facility rates across CMS payment localities in Iowa.
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 Q4204 in Iowa?
Iowa 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
$116.44
1 of 1 localities have a supported rate.
Payment area: Iowa
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 product
About Q4204: Xwrap wound product by area
Report Q4204 for each square centimeter of Xwrap furnished for wound treatment, together with the primary procedure that applies the product.
Q4204 identifies Xwrap, a wound-care product measured by square centimeter. It represents the product rather than the wound-application procedure. Physicians and other clinicians providing wound care may use it when Xwrap is applied to a wound in an outpatient or facility setting. The code is specific to Xwrap; a different wound product requires its own applicable product code.
Report the documented quantity of Xwrap in square centimeters with the primary procedure for applying it. The CMS rule classifies Q4204 as an add-on: it must be billed with a primary procedure, and its payment falls within that procedure’s global period. The code is technical-component only; a separate code covers interpretation. Keep the product identity and quantity in the record, along with the primary procedure and treated wound, so the billed units can be traced to the service.
CMS billing rules for Q4204
- 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.
Q4204 compared with similar codes
Office rates for Iowa, from the same CMS release.
$293.57
Q4204 is the product code. Use 15273 for the application procedure at qualifying head or neck sites.
$116.44
Q4205 identifies a separately named membrane graft or wrap product. Use Q4204 when the product furnished is Xwrap.
Compare Q4204 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
Iowa →
Office / nonfacility
$116.44
Facility
Unavailable
Need rates for a whole code list?
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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 Q4204 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
18,296
- Code
- Q4204
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.915 | 3.4862 |
| Malpractice | 0.00 | × 0.397 | 0.0000 |
| Total RVUs | 3.4862 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$116.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.915 |
| Malpractice | 0 | 0.397 |
(0 × 1 + 3.81 × 0.915 + 0 × 0.397) × $33.4009 = $116.44
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.
Q4204 billing questions
Is Q4204 the wound-application procedure?
No. Q4204 identifies the Xwrap product by area; report the applicable primary wound-application procedure separately.
How are Q4204 units determined?
Use the number of square centimeters of Xwrap represented by the service. Document the product and quantity so the units can be supported.
Can Q4204 be billed by itself?
No. It is an add-on and must be billed with a primary procedure. Its payment is included within that procedure’s global period.
Does Q4204 include interpretation?
No. Q4204 is technical-component only; a separate code covers interpretation.
How is Q4204 different from Q4205?
Q4204 identifies Xwrap. Q4205 identifies a separately named membrane graft or wrap product, so select the code for the product actually furnished.
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.
18,293Q4201,,Matrion 1 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
18,294Q4202,,"Keroxx (2.5g/cc), 1cc",C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,295Q4203,,"Derma-gide, 1 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
18,296Q4204,,Xwrap 1 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
18,297Q4205,,Membrane graft or wrap 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
18,298Q4206,,Fluid flow or fluid gf 1 cc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,3,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
18,299Q4207,,"Carbon life, per sq cm",A,,0.00,3.81,,3.81,NA,0.00,3.81,3.81,3,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136