$113.13
Q4252 identifies Vendaje, not Zenith. Select the product code that matches the material supplied; the similar unit basis does not make the products interchangeable.
On this page
CMS RVU26D · Effective 2026-10-01
Q4253 Amniotic membrane Medicare reimbursement rates in Kentucky
Q4253 reports the Zenith amniotic membrane supplied for wound coverage, measured by the square centimeter and billed with an appropriate application procedure. Compare Q4253 office and facility rates across CMS payment localities in Kentucky.
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 Q4253 in Kentucky?
Kentucky 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
$113.13
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 Q4253: Zenith amniotic membrane product
Q4253 reports the Zenith amniotic membrane supplied for wound coverage, measured by the square centimeter and billed with an appropriate application procedure.
Q4253 identifies the Zenith amniotic membrane product used for wound coverage. It is typically supplied for application to a wound by a physician or other qualified clinician in a wound-care, podiatry, surgical, or outpatient setting. The application procedure and the product supply are distinct reporting elements: the procedure code describes applying the material, while Q4253 identifies the product furnished.
Report the quantity in square centimeters and document the wound site, treated area, product used, and associated application procedure. Select the application code based on the wound location and treated area; codes such as 15271 or 15273 may apply when their site and area criteria are met. CMS treats Q4253 as an add-on code, so report it only with a primary procedure and within that procedure's global period. CMS also classifies it as technical-component-only, with interpretation covered by a separate code.
CMS billing rules for Q4253
- 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.
Q4253 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$113.13
Q4254 identifies NovaFix DL, a different product. Use Q4253 only when Zenith was the membrane supplied.
$146.05
15271 describes an application procedure, not the Zenith product. Report it when its site and area criteria fit, with Q4253 for the product supplied.
Compare Q4253 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
Kentucky →
Office / nonfacility
$113.13
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 Q4253 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
18,341
- Code
- Q4253
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.889 | 3.3871 |
| Malpractice | 0.00 | × 0.915 | 0.0000 |
| Total RVUs | 3.3871 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$113.13
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.889 |
| Malpractice | 0 | 0.915 |
(0 × 1 + 3.81 × 0.889 + 0 × 0.915) × $33.4009 = $113.13
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.
Q4253 billing questions
Can Q4253 be billed by itself?
No. CMS identifies it as an add-on code, so it must be reported with a primary procedure and within that procedure's global period.
How do I choose the application procedure?
Choose the application code using the wound's anatomic site and treated area. For example, 15271 and 15273 apply to different site groupings; confirm the applicable code's criteria.
How should the Q4253 quantity be reported?
Report the product in square centimeters. The record should support the treated area and the amount of Zenith product used.
Does Q4253 include interpretation?
No. CMS classifies Q4253 as technical-component-only; a separate code covers interpretation.
What documentation supports Q4253?
Document the wound location and size, the area treated, the Zenith product supplied, its quantity in square centimeters, and the associated 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.
18,338Q4250,,Amnioamp-mp 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
18,339Q4251,,"Vim, per square centimeter",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
18,340Q4252,,"Vendaje, per square centimet",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
18,341Q4253,,Zenith amniotic membrane psc,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
18,342Q4254,,Novafix 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
18,343Q4255,,"Reguard, topical use per sq",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
18,344Q4256,,"Mlg complet, 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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631