HCPCS code Q4225: Skin substitute2026 Medicare rate & RVUs in Washington
Q4225 reports Amnio or DermaTL wound product by square centimeter when the product is supplied with a qualifying wound-application procedure.
Medicare pays $134.00–$156.14 for Q4225 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 Q4225 covers
Q4225 identifies Amnio or DermaTL, a wound-care tissue product supplied in square-centimeter units. It is used when this specific product is applied to a wound, commonly in outpatient wound care by a physician or other qualified practitioner. The product code identifies the supply; the wound-site application is reported separately with the applicable procedure code.
Report units based on the documented quantity of Amnio or DermaTL supplied, and retain records identifying the product, wound site, and amount used. CMS classifies Q4225 as an add-on code: bill it only with a primary procedure, and its payment is included within that procedure’s global period. CMS also classifies it as technical-component-only; professional interpretation is represented by a separate code rather than included in Q4225.
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 Q4225 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $134.00 | Unavailable |
| Seattle (King Cnty) | $156.14 | Unavailable |
How the Q4225 rate is calculated
Each of Q4225’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 · Q4225
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 Q4225
The CMS indicators that decide how Q4225 is paid alongside other services.
CMS payment indicators · Q4225
Skin substitute
| 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. |
Q4225 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- Q4221Wound product
- Q4221 identifies AmnioWrap2. Use Q4225 for Amnio or DermaTL, not merely because both products are billed by square centimeter.
- Q4223Ocular membrane product
- Q4223 identifies Dermabind SL Optic, a different product. Q4225 applies to Amnio or DermaTL.
- Q4227Amniocore
- Q4227 identifies AmnioCore. Choose between it and Q4225 according to the product actually supplied, not the wound location alone.
Q4225 billing questions
Can Q4225 be billed by itself?
No. CMS identifies Q4225 as an add-on code, so it must be billed with the applicable primary wound-application procedure.
How is the number of units determined?
The code is measured per square centimeter. Document the quantity of Amnio or DermaTL supplied and the wound site receiving it.
Is the wound application included in Q4225?
No. Q4225 identifies the product; report the applicable wound-application procedure separately as the primary service.
Does Q4225 include professional interpretation?
No. CMS classifies Q4225 as technical-component-only and indicates that a separate code covers interpretation.
Can Q4225 be substituted for another amniotic or dermal product code?
No. Select the code matching the specific product supplied; a similar tissue type or wound use does not make product codes interchangeable.
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 Q4225 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 →