HCPCS Q4355: Wound materialMedicare rate & RVUs in Washington
Report Abio XPL or Abio XPL HY by square centimeter when this material is supplied during a separately reported wound application procedure.
Medicare pays $134.00–$156.14 for Q4355 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 Q4355 covers
Q4355 identifies Abio XPL or Abio XPL HY material supplied for placement on a wound. A clinician performing the application may use the material as part of wound coverage in an office or facility. This code identifies the specific product, rather than the clinician’s work of preparing the wound and placing the material.
Select Q4355 only when the treatment record identifies Abio XPL or Abio XPL HY, and report the quantity in square centimeters. Document the product used, the wound site, the measured area, and the accompanying application procedure. CMS classifies Q4355 as an add-on code: it is billed with a primary procedure and paid within that procedure’s global period. CMS also classifies it as technical-component-only. Q4355 therefore represents the technical portion; a separate code covers interpretation when that service is reported.
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 Q4355 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $134.00 | Unavailable |
| Seattle (King Cnty) | $156.14 | Unavailable |
How the Q4355 rate is calculated
Each of Q4355’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 · Q4355
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 Q4355
The CMS indicators that decide how Q4355 is paid alongside other services.
CMS payment indicators · Q4355
Wound material
| 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. |
Q4355 compared with similar codes
Compare codes
Q4355 vs Q4356 vs Q4364 vs 15271: national Medicare rates
Swap in your local Medicare rate.
How to choose
- Q4356Wound matrix
- Both codes identify Abio products by square centimeter. Q4355 is for Abio XPL or Abio XPL HY; Q4356 is for Abio MEM or Abio HYD.
- Q4364Amniotic membrane
- Q4364 identifies a different named amniotic membrane product. Use Q4355 only when the product record identifies Abio XPL or Abio XPL HY.
- 15271Skin substitute graft
- Q4355 identifies the Abio material supplied. Code 15271 describes the clinician’s skin-substitute application procedure when the wound site and size meet its criteria.
Q4355 billing questions
When is Q4355 reported instead of Q4356?
Use Q4355 for Abio XPL or Abio XPL HY. Q4356 identifies Abio MEM or Abio HYD; select the code that matches the documented product.
Does Q4355 replace the wound application procedure code?
No. Q4355 identifies the material by square centimeter and is billed with a primary procedure for its application.
How are units determined for Q4355?
The code is expressed per square centimeter. The record should identify the Abio product and support the quantity reported.
Is interpretation included in Q4355?
CMS classifies Q4355 as technical-component-only. A separate code covers interpretation when that service is reported.
How does the primary procedure’s global period affect Q4355?
Q4355 is an add-on billed with the primary procedure and paid within that procedure’s global period.
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
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