HCPCS Q4264: Wound membraneMedicare rate & RVUs in Utah
Reports Cocoon membrane by square centimeter when furnished for wound coverage with a separately coded primary application procedure.
Medicare pays $119.62 for Q4264 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 Q4264 covers
Q4264 identifies Cocoon membrane supplied for wound coverage, with the quantity measured in square centimeters. It represents the product, not the clinician’s wound preparation or placement service. Wound-care clinicians may use the membrane in outpatient treatment of wounds; the application procedure is coded separately according to wound location and treated area.
CMS classifies Q4264 as an add-on, so report it only with a primary procedure; payment is handled within that procedure’s global period. Base the quantity on the Cocoon membrane furnished and keep documentation linking the product and amount to the treated wound. CMS identifies this as a technical-component-only code, with interpretation covered by a separate code. The CMS work RVU is zero, so the application service must be represented 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.
Q4264 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $119.62 | Unavailable |
How the Q4264 rate is calculated
Each of Q4264’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 · Q4264
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 Q4264
The CMS indicators that decide how Q4264 is paid alongside other services.
CMS payment indicators · Q4264
Wound membrane
| 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. |
Q4264 compared with similar codes
Compare codes
Q4264 vs Q4253 vs Q4263 vs 15271: national Medicare rates
Swap in your local Medicare rate.
How to choose
- Q4253Amniotic membrane
- Q4253 identifies Zenith amniotic membrane, while Q4264 identifies Cocoon membrane. Select the code matching the product furnished.
- Q4263Surgraft TL
- Q4263 identifies Surgraft TL rather than Cocoon membrane. These product-specific supply codes are not interchangeable based only on the wound site.
- 15271Skin substitute graft
- 15271 reports the application service for the specified body regions and area range; Q4264 reports the Cocoon membrane product by square centimeter.
Q4264 billing questions
How is Q4264 different from the wound application procedure?
Q4264 reports the Cocoon membrane product by square centimeter. Report the applicable wound application procedure separately for the clinician’s placement service.
Can Q4264 be reported by itself?
No. CMS classifies it as an add-on code that must be reported with a primary procedure.
How should the quantity be determined?
Use the square centimeters of Cocoon membrane furnished for the wound, supported by the product and amount documented for the service.
Does this code include interpretation?
No. CMS identifies Q4264 as technical-component-only; a separate code covers interpretation.
Why does the primary procedure matter for payment?
CMS places payment for Q4264 within the primary procedure’s global period, so it is reported with that procedure rather than as a stand-alone service.
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
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