HCPCS Q4250: Wound allograftMedicare rate & RVUs in Utah
Q4250 reports the AmnioAMP-MP amniotic membrane product, measured by square centimeter, when supplied for application to a wound.
Medicare pays $119.62 for Q4250 in the office in Utah (Utah). 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 Q4250 covers
Q4250 identifies the AmnioAMP-MP amniotic membrane product by the square centimeter. It represents the product supplied for wound coverage, not the clinician’s work applying it. Wound care clinicians, surgeons, and podiatrists may use this type of membrane during treatment of wounds in office, outpatient, or surgical settings. The product code is reported with the primary procedure that applies the membrane, such as an appropriate skin substitute application service.
Report units according to the square centimeters of product supplied, supported by the product record and documentation of the wound site, dimensions, and amount used. Q4250 is an add-on code: bill it only with a primary procedure, and payment falls within that procedure’s global period. It is a technical-component-only code; a separate code covers interpretation. The application service and the product are distinct coding elements, so the application procedure must be reported separately when performed.
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.
Q4250 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $119.62 | Unavailable |
How the Q4250 rate is calculated
Each of Q4250’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 · Q4250
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 Q4250
The CMS indicators that decide how Q4250 is paid alongside other services.
CMS payment indicators · Q4250
Wound allograft
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 3 | Technical component only. |
Q4250 compared with similar codes
Compare codes
Q4250 vs 15271 vs 15275 vs Q4247: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 15271Skin substitute graft
- 15271 reports the primary application service for eligible wounds on the trunk, arms, or legs; Q4250 reports the AmnioAMP-MP product supplied with that service.
- 15275Skin substitute
- 15275 reports the primary application service for eligible wounds on the head, face, digits, or genitalia; Q4250 identifies the product, not the application work.
- Q4247Amniotext patch
- Q4247 identifies Amniotext patch per square centimeter, whereas Q4250 identifies AmnioAMP-MP per square centimeter. Select the product code matching the item supplied.
Q4250 billing questions
Can Q4250 be billed by itself?
No. It is an add-on product code and must be billed with a primary procedure, such as an appropriate skin substitute application service.
How are units determined?
The unit of measure is one square centimeter. Document the product amount supplied and the wound dimensions that support the reported units.
Does Q4250 include the clinician’s application work?
No. Q4250 identifies the AmnioAMP-MP product; report the applicable primary procedure separately for the work of applying it.
Is interpretation included in Q4250?
No. CMS identifies Q4250 as technical-component-only, with interpretation covered by a separate code.
How does Q4250 differ from Q4247?
Q4250 identifies AmnioAMP-MP per square centimeter, while Q4247 identifies Amniotext patch per square centimeter. Report the code for 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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