$125.98
Q4253 identifies Zenith amniotic membrane, while Q4264 identifies Cocoon membrane. Select the code matching the product furnished.
On this page
CMS RVU26D · Effective 2026-10-01
Q4264 Wound membrane Medicare reimbursement rates in Vermont
Reports Cocoon membrane by square centimeter when furnished for wound coverage with a separately coded primary application procedure. Compare Q4264 office and facility rates across CMS payment localities in Vermont.
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 Q4264 in Vermont?
Vermont 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
$125.98
1 of 1 localities have a supported rate.
Payment area: Vermont
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 supply
About Q4264: Cocoon membrane wound coverage
Reports Cocoon membrane by square centimeter when furnished for wound coverage with a separately coded primary application procedure.
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.
CMS billing rules for Q4264
- 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%
8.5K
Medicare services in 2024 · #1564 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.
Q4264 compared with similar codes
Office rates for Vermont, from the same CMS release.
$125.98
Q4263 identifies Surgraft TL rather than Cocoon membrane. These product-specific supply codes are not interchangeable based only on the wound site.
$153.50
15271 reports the application service for the specified body regions and area range; Q4264 reports the Cocoon membrane product by square centimeter.
Compare Q4264 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
Vermont →
Office / nonfacility
$125.98
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 Q4264 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
18,352
- Code
- Q4264
- Physician work
- 0.00
- Practice expense
- 3.81
- Malpractice
- 0.00
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 3.81 | × 0.990 | 3.7719 |
| Malpractice | 0.00 | × 0.506 | 0.0000 |
| Total RVUs | 3.7719 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$125.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 3.81 | 0.99 |
| Malpractice | 0 | 0.506 |
(0 × 1 + 3.81 × 0.99 + 0 × 0.506) × $33.4009 = $125.98
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.
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 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.
18,349Q4261,,"Tag, per square centimeter",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
18,350Q4262,,"Dual layer impax, 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
18,351Q4263,,"Surgraft tl, 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
18,352Q4264,,"Cocoon membrane, 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
18,353Q4265,,Neostim tl 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
18,354Q4266,,Neostim 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
18,355Q4267,,Neostim 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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817