HCPCS Q4198: Amniotic membraneMedicare rate & RVUs in Washington
Q4198 reports Genesis amniotic membrane supplied for wound coverage, measured in square centimeters and billed with the primary application procedure.
Medicare pays $134.00–$156.14 for Q4198 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 Q4198 covers
Q4198 represents Genesis amniotic membrane used as a wound-covering product during treatment of a wound. A wound care clinician, surgeon, or other qualified practitioner may apply the membrane to a prepared wound bed in an office or facility setting. The code reports the product, not the clinical work of evaluating the wound or performing the application.
Report one unit for each square centimeter of Genesis membrane supplied, with the primary procedure for applying the product. The record should identify Genesis, document the wound site and size, and support the quantity applied. CMS classifies Q4198 as an add-on code: it is not billed alone, and its payment is within the primary procedure’s global period. It is also a technical-component-only code; a separate code covers interpretation.
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.
Where Q4198 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $134.00 | Unavailable |
| Seattle (King Cnty) | $156.14 | Unavailable |
How the Q4198 rate is calculated
Each of Q4198’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 · Q4198
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense3.81
3.81 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
3.8100
Conversion factor
$33.4009
Medicare rate
$127.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for Q4198
The CMS indicators that decide how Q4198 is paid alongside other services.
CMS payment indicators · Q4198
Amniotic 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. |
Q4198 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4186EpiFix material
- Q4198 identifies Genesis amniotic membrane; Q4186 identifies EpiFix. Choose the code matching the product supplied, not simply the wound type.
- Q4187Wound product
- Q4187 identifies Epicord rather than Genesis. Both use a square-centimeter unit, but the product identity determines the HCPCS code.
- Q4199Wound matrix
- Q4199 identifies Cygnus Matrix, not Genesis amniotic membrane. Report the code corresponding to the product used.
Q4198 billing questions
What does one unit of Q4198 represent?
One unit represents one square centimeter of Genesis amniotic membrane. Document the product and the area supplied or applied.
Can Q4198 be billed by itself?
No. CMS identifies it as an add-on code that must be billed with a primary procedure.
Which application procedure should accompany Q4198?
Pair it with the primary procedure that describes application of the wound-covering product. Select the application code according to the documented wound site and area.
Is Q4198 the code for the clinician’s application work?
No. Q4198 reports the Genesis product. The primary procedure reports the application service.
What does the technical-component-only designation mean?
CMS classifies Q4198 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
Show the CMS file lines behind this rate
Fee sheets
Put Q4198 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →