HCPCS Q4223: Ocular membrane productMedicare rate & RVUs in Oregon
Reports the per-square-centimeter Dermabind SL Optic membrane supplied for ophthalmic treatment when paired with a qualifying primary procedure.
Medicare pays $126.75–$141.38 for Q4223 in the office in Oregon, from Rest Of Oregon to Portland. 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 Q4223 covers
Q4223 identifies the Dermabind SL Optic product by the area supplied, rather than the clinician’s work applying it. It is used in ophthalmic care involving an ocular-surface defect, with an ophthalmologist typically selecting and placing the membrane in an office procedure room or outpatient surgical setting. The product code is distinct from the procedure that prepares or treats the ocular surface.
Report Q4223 only with a primary procedure; CMS treats it as an add-on paid within that procedure’s global period. Document the product name and the square-centimeter amount used, and report the application or reconstruction procedure separately. CMS classifies Q4223 as technical-component-only, with a separate code covering interpretation. The product’s quantity is based on its documented area, not the number of eyes or visits.
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 Q4223 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $141.38 | Unavailable |
| Rest Of Oregon | $126.75 | Unavailable |
How the Q4223 rate is calculated
Each of Q4223’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 · Q4223
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.00Practice expense 3.81Malpractice 0.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4223
The CMS indicators that decide how Q4223 is paid alongside other services.
CMS payment indicators · Q4223
Ocular membrane product
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 9 | The concept doesn’t apply. |
| Bilateral (modifier 50) | 9 | The concept doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 9 | The concept doesn’t apply. |
| Co-surgeons (62) | 9 | The concept doesn’t apply. |
| Team surgery (66) | 9 | The concept doesn’t apply. |
| Professional/technical | 3 | Technical component only. |
Q4223 compared with similar codes
Compare codes
Q4223 vs 65778 vs 65779 vs Q4222 vs Q4224: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 65778Amniotic membrane
- 65778 reports the ocular-surface procedure using a self-retaining membrane. Q4223 identifies the Dermabind SL Optic product by area; it does not describe the procedure.
- 65779Amniotic membrane
- 65779 reports an ocular-surface procedure using a sutured membrane. Q4223 reports the Dermabind SL Optic product supplied, not the method of placement.
- Q4222Wound matrix
- Q4222 identifies Progenamatrix by area, while Q4223 identifies Dermabind SL Optic. Choose according to the product documented as supplied.
- Q4224Wound matrix
- Q4224 identifies HHF10-P by area. Q4223 is specific to Dermabind SL Optic, even though both descriptors use a square-centimeter unit.
Q4223 billing questions
Can Q4223 be billed by itself?
No. CMS identifies it as an add-on code, so report it with a primary procedure. Its payment falls within that procedure’s global period.
How should the units be determined?
Use the square-centimeter amount of Dermabind SL Optic supplied, supported by the product documentation and the clinical record.
Does Q4223 include the ocular procedure?
No. Q4223 identifies the product supply; report the applicable ocular-surface procedure separately.
Does this code include professional interpretation?
No. CMS classifies Q4223 as technical-component-only, with interpretation covered by a separate code.
How does Q4223 differ from Q4222 or Q4224?
Q4223 identifies Dermabind SL Optic. Q4222 and Q4224 identify different named products, so select the code matching the product actually supplied.
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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