$116.82–$132.47
Q4150 identifies Allowrap DS or Dry; Q4151 identifies Amnioband or Guardian. Select the code for the product actually furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4151 Amniotic membrane Medicare reimbursement rates in Pennsylvania
Reports the Amnioband/Guardian amniotic membrane wound product by square centimeter when supplied for graft coverage of a wound. Compare Q4151 office and facility rates across CMS payment localities in Pennsylvania.
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 Q4151 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$116.82–$132.47
2 of 2 localities have a supported rate.
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 Q4151: Amniotic membrane wound product
Reports the Amnioband/Guardian amniotic membrane wound product by square centimeter when supplied for graft coverage of a wound.
Q4151 identifies Amnioband or Guardian, an amniotic membrane-based wound product supplied for coverage of a prepared wound bed. It represents the product rather than the clinician’s application service. Wound-care clinicians, podiatrists, and surgeons may use the material in office wound clinics or hospital outpatient settings as part of wound treatment.
Report the code only with a primary procedure; CMS treats it as an add-on and pays it within that procedure’s global period. Select Q4151 based on the specific product furnished, and report units according to the product’s one-square-centimeter billing unit. Documentation should identify the product, wound site, treated area, amount used, and associated primary procedure. CMS classifies Q4151 as technical-component-only; a separate code represents interpretation.
CMS billing rules for Q4151
- 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.
Q4151 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$116.82–$132.47
Q4152 identifies Dermapure, not Amnioband or Guardian. The shared square-centimeter unit does not make the product codes interchangeable.
$149.22–$164.41
15271 reports the primary application procedure for qualifying trunk, arm, or leg wounds; Q4151 reports the Amnioband/Guardian product supplied with a primary procedure.
Compare Q4151 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$132.47
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$116.82
Facility
Unavailable
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Q4151 billing questions
When should Q4151 be selected instead of another skin substitute product code?
Use Q4151 when the product furnished is Amnioband or Guardian. Other wound products have their own HCPCS codes, even when they are also supplied by area.
Can Q4151 be billed by itself?
No. CMS identifies it as an add-on code that must be reported with a primary procedure and paid within that procedure’s global period.
How is the quantity reported?
The code’s billing unit is one square centimeter. Document the treated area and the amount of Amnioband or Guardian used.
Does Q4151 include the wound application service?
No. Q4151 identifies the product; report the applicable primary wound procedure separately for the clinician’s application service.
Does Q4151 include interpretation?
No. CMS classifies Q4151 as technical-component-only and indicates that 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.
18,241Q4148,,Neox neox rt or clarix cord,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
18,242Q4149,,"Excellagen, 0.1 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
18,243Q4150,,Allowrap ds or dry 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
18,244Q4151,,"Amnioband, guardian 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
18,245Q4152,,Dermapure 1 square 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
18,246Q4153,,"Dermavest, plurivest 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
18,247Q4154,,Biovance 1 square 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