HCPCS Q4294: Amniotic graftMedicare rate & RVUs in Utah
Reports Amnio Quad-Core amniotic wound product by square centimeter when supplied with a primary wound procedure for a skin defect.
Medicare pays $119.62 for Q4294 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 Q4294 covers
Q4294 identifies Amnio Quad-Core, an amniotic wound product supplied by area for use in wound treatment. Wound-care physicians, surgeons, and podiatrists may use it during treatment of skin defects such as diabetic foot ulcers or venous leg ulcers. The application procedure addresses the wound; this code identifies the product used rather than the clinical work of applying it.
Report Q4294 only with a primary procedure, using units that reflect the square centimeters represented by the product. Documentation should identify the product, wound site and size, and amount used. CMS treats the code as an add-on paid within the primary procedure’s global period. It is technical-component-only; a separate code covers interpretation. The code has no separate work value in the CMS physician fee schedule facts provided.
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.
Q4294 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $119.62 | Unavailable |
How the Q4294 rate is calculated
Each of Q4294’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 · Q4294
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 Q4294
The CMS indicators that decide how Q4294 is paid alongside other services.
CMS payment indicators · Q4294
Amniotic graft
| 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. |
Q4294 compared with similar codes
Compare codes
Q4294 vs Q4295 vs 15271 vs 15275: national Medicare rates
Swap in your local Medicare rate.
How to choose
- Q4295Amniotic tissue product
- Q4295 identifies Amnio Tri-Core; Q4294 identifies Amnio Quad-Core. Match the claim to the product actually supplied.
- 15271Skin substitute graft
- Q4294 reports the Amnio Quad-Core product by area. Code 15271 reports the primary application service for qualifying trunk, arm, or leg wounds.
- 15275Skin substitute
- Q4294 identifies the product supplied. Code 15275 reports the primary application service for qualifying wounds on the head, face, neck, hand, foot, or genitalia.
Q4294 billing questions
How is Q4294 different from Q4295?
Q4294 identifies Amnio Quad-Core, while Q4295 identifies Amnio Tri-Core. Select the code that matches the product supplied; the names do not make the products interchangeable.
Is Q4294 reported by wound area or product amount?
The unit is per square centimeter. Document the wound site and size and the amount of Amnio Quad-Core used to support the units reported.
Can Q4294 be billed without a wound procedure?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
Does Q4294 include the work of applying the product?
Q4294 identifies the product, not the application service. Report the applicable primary wound procedure for the application.
How does the global-period rule affect Q4294?
Payment for Q4294 is within the primary procedure’s global period; it is not treated as a separate service outside that procedure’s period.
Is interpretation included in Q4294?
CMS classifies Q4294 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 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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