$161.53
15271 reports the application service for its specified body sites; Q4289 reports the Revoshield+ product quantity used with a primary application procedure.
On this page
CMS RVU26D · Effective 2026-10-01
Q4289 Wound product Medicare reimbursement rates in Rhode Island
Reports the square-centimeter quantity of Revoshield+ amniotic wound material used with a primary skin-substitute application procedure. Compare Q4289 office and facility rates across CMS payment localities in Rhode Island.
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 Q4289 in Rhode Island?
Rhode Island 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
$131.46
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 products
About Q4289: Revoshield+ amniotic wound product
Reports the square-centimeter quantity of Revoshield+ amniotic wound material used with a primary skin-substitute application procedure.
Q4289 identifies the Revoshield+ amniotic product supplied for wound coverage, measured in square centimeters. It is generally reported by clinicians applying an amniotic membrane product during outpatient wound care, such as treatment of a chronic lower-extremity ulcer. The product line is distinct from the clinical work of preparing and treating the wound.
Report the quantity in square centimeters and pair Q4289 with the primary application procedure selected for the wound site and treated area; it is not a standalone application service. CMS treats it as an add-on paid within the primary procedure’s global period. CMS also classifies it as technical-component-only, with interpretation covered by a separate code. Documentation should identify Revoshield+, the wound location, product quantity, and corresponding application procedure.
CMS billing rules for Q4289
- 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%
10.3K
Medicare services in 2024 · #1453 by national volume
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.
Q4289 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$163.84
15275 represents application work for a different group of body sites. Q4289 identifies the Revoshield+ product, not the application service.
$131.46
Q4280 identifies Xcell amnio matrix, while Q4289 identifies Revoshield+. Select the product code that matches the material used.
$131.46
Q4294 identifies amnio quad-core rather than Revoshield+. These product-specific codes are not interchangeable based solely on the wound site.
Compare Q4289 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
Rhode Island →
Office / nonfacility
$131.46
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 Q4289 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
18,376
- Code
- Q4289
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.019 | 0.0000 |
| Practice expense | 3.81 | × 1.033 | 3.9357 |
| Malpractice | 0.00 | × 0.892 | 0.0000 |
| Total RVUs | 3.9357 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$131.46
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1.019 |
| Practice expense | 3.81 | 1.033 |
| Malpractice | 0 | 0.892 |
(0 × 1.019 + 3.81 × 1.033 + 0 × 0.892) × $33.4009 = $131.46
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.
Q4289 billing questions
Can Q4289 be billed by itself?
No. CMS identifies it as an add-on code, so report it with the applicable primary procedure rather than as a standalone service.
Which application procedure should accompany Q4289?
Choose the primary skin-substitute application procedure according to the treated body site and wound area. For example, 15271 and 15275 address different site groups.
How should the units be determined?
The code is measured per square centimeter. Document the product quantity associated with the application and the wound measurements supporting treatment.
Does Q4289 include the clinician’s wound application work?
Q4289 represents the Revoshield+ product quantity. Report the primary application procedure separately to represent the application service.
How does the technical-component rule affect reporting?
CMS classifies Q4289 as technical-component-only; a separate code covers interpretation.
What documentation supports Q4289?
Record the Revoshield+ product, the treated wound location, the square-centimeter quantity, and the primary 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.
18,373Q4286,,"Nudyn sl or slw, 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
18,374Q4287,,"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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537