$149.22–$164.41
15271 reports the application service for an eligible wound site; Q4290 reports the membrane-wrap material by square centimeter.
On this page
CMS RVU26D · Effective 2026-10-01
Q4290 Membrane wrap Medicare reimbursement rates in Pennsylvania
Reports hydrated membrane wrap material used with a wound application procedure, with units based on the product quantity measured in square centimeters. Compare Q4290 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 Q4290 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.
Skin substitute supply
About Q4290: Hydrated membrane wrap supply
Reports hydrated membrane wrap material used with a wound application procedure, with units based on the product quantity measured in square centimeters.
Q4290 identifies a hydrated membrane-wrap product supplied for use in wound care. It represents the material, not wound preparation or the clinician’s application service. Wound-care clinicians, surgeons, and other practitioners may use the product in office or outpatient settings when treating a wound that calls for membrane coverage.
Report Q4290 with the primary procedure, using the product’s square-centimeter measure and documenting the product, wound site, amount used, and related application. CMS classifies the code as an add-on, so it is not reported alone and is paid within the primary procedure’s global period. CMS also designates it as technical-component-only; a separate code covers interpretation.
CMS billing rules for Q4290
- 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.
Q4290 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$116.82–$132.47
Q4289 identifies Revoshield+ amnio material, while Q4290 identifies hydrated membrane-wrap material. Choose the code matching the product used, not simply the wound size.
$116.82–$132.47
Q4280 identifies Xcell amnio matrix; Q4290 identifies a different membrane-wrap product. The product identity determines which supply code applies.
Compare Q4290 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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Q4290 billing questions
Can Q4290 be reported by itself?
No. CMS identifies it as an add-on code, so report it only with a primary procedure.
Is Q4290 the wound application service?
No. Q4290 represents the membrane-wrap material; report the appropriate wound application procedure separately.
How should units be determined?
The code is measured per square centimeter. Document the amount of Q4290 product used and the wound to which it was applied.
What documentation supports reporting Q4290?
Record the product identity, wound location, quantity used in square centimeters, and the associated primary application procedure.
How is the interpretation handled?
CMS designates Q4290 as technical-component-only, with interpretation covered by a separate code.
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.
18,374Q4287,,"Dermabind 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
18,375Q4288,,"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