$117.46
Q4292 identifies Lamellas, while Q4291 identifies Lamellas XT. Choose according to the product actually furnished, not simply because both are billed by square centimeter.
On this page
CMS RVU26D · Effective 2026-10-01
Q4291 Wound product Medicare reimbursement rates in Nebraska
Q4291 reports the area of Lamellas XT wound product furnished with a primary procedure, billed by square centimeter rather than as the application service. Compare Q4291 office and facility rates across CMS payment localities in Nebraska.
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 Q4291 in Nebraska?
Nebraska 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
$117.46
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 Q4291: Lamellas XT wound product supply
Q4291 reports the area of Lamellas XT wound product furnished with a primary procedure, billed by square centimeter rather than as the application service.
Q4291 identifies Lamellas XT wound product supplied for wound coverage, measured by area. It represents the product, not the clinician’s work to prepare or apply it. It may be reported in outpatient wound clinics, hospital outpatient departments, or other settings where a clinician performs a related wound procedure. The clinical record should identify the wound treated, the product used, and the square-centimeter quantity supported by the service.
CMS classifies Q4291 as an add-on code, so report it only with a primary procedure; its payment falls within that procedure’s global period. The code is technical-component-only, with interpretation covered by a separate code. Select Q4291 when the product furnished is Lamellas XT, rather than another wound product with its own HCPCS code. Keep the product quantity distinct from the primary procedure’s application or treatment service, and ensure the documentation supports both the primary service and the area reported.
CMS billing rules for Q4291
- 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.
Q4291 compared with similar codes
Office rates for Nebraska, from the same CMS release.
$145.75
Q4291 reports the Lamellas XT product quantity; 15271 reports a primary wound application service when its site and area criteria are met. The product code is not a substitute for the procedure code.
$117.46
Q4290 identifies Membrane Wrap Hydr, a different product. Use Q4291 only when the material furnished is Lamellas XT.
Compare Q4291 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
Nebraska →
Office / nonfacility
$117.46
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 Q4291 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
18,378
- Code
- Q4291
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.923 | 3.5166 |
| Malpractice | 0.00 | × 0.378 | 0.0000 |
| Total RVUs | 3.5166 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$117.46
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.923 |
| Malpractice | 0 | 0.378 |
(0 × 1 + 3.81 × 0.923 + 0 × 0.378) × $33.4009 = $117.46
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.
Q4291 billing questions
When should I use Q4291 instead of Q4292?
Use Q4291 for Lamellas XT. Q4292 identifies Lamellas; the product actually furnished determines which code to report.
Can Q4291 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure, and its payment is within that procedure’s global period.
Does Q4291 include the application service?
No. Q4291 reports the Lamellas XT product by area. Report the primary procedure separately when performed and supported by the record.
How should the quantity be documented?
Document the wound treated, the Lamellas XT product used, and the square-centimeter quantity supported by the service.
Is interpretation included in Q4291?
No. CMS classifies Q4291 as technical-component-only; a separate code covers interpretation.
Does CMS specify a modifier for Q4291?
The CMS facts provided establish add-on and component status, but no Q4291-specific modifier rule. The documentation should support the product quantity and the paired primary service.
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.
18,375Q4288,,"Dermabind ch, 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
18,376Q4289,,"Revoshield+ amnio, 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
18,377Q4290,,Membrane wrap hydr 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
18,378Q4291,,"Lamellas xt, 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
18,379Q4292,,"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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068