Q4009 HCPCS code: Cast supplies, short arm cast, adult (11 years +), plaster
Q4009 is the HCPCS Level II code for cast supplies, short arm cast, adult (11 years +), plaster. The 2026 Medicare DMEPOS fee schedule pays $11.03 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on outpatient hospital claims. Medicare volume fell 3% from 2022 to 2024 (918 to 888 services). In 2024, about 312 clinicians billed Medicare for Q4009 for 717 beneficiaries; Maryland, Michigan, New York accounted for 44% of services. Its average fee ranks 12 of 49 Q40 codes (family range $2.68–$235.64).
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 55 |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 2001-07-01 |
| Last action effective | 2014-10-01 |
2026 Medicare DMEPOS fee schedule for Q4009
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $11.03 | $11.03 | $11.03 | $9.38 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $11.03 | — |
| AL | — | $11.03 | — |
| AR | — | $11.03 | — |
| AZ | — | $11.03 | — |
| CA | — | $11.03 | — |
| CO | — | $11.03 | — |
| CT | — | $11.03 | — |
| DC | — | $11.03 | — |
| DE | — | $11.03 | — |
| FL | — | $11.03 | — |
| GA | — | $11.03 | — |
| HI | — | $11.03 | — |
| IA | — | $11.03 | — |
| ID | — | $11.03 | — |
| IL | — | $11.03 | — |
| IN | — | $11.03 | — |
| KS | — | $11.03 | — |
| KY | — | $11.03 | — |
| LA | — | $11.03 | — |
| MA | — | $11.03 | — |
| MD | — | $11.03 | — |
| ME | — | $11.03 | — |
| MI | — | $11.03 | — |
| MN | — | $11.03 | — |
| MO | — | $11.03 | — |
| MS | — | $11.03 | — |
| MT | — | $11.03 | — |
| NC | — | $11.03 | — |
| ND | — | $11.03 | — |
| NE | — | $11.03 | — |
| NH | — | $11.03 | — |
| NJ | — | $11.03 | — |
| NM | — | $11.03 | — |
| NV | — | $11.03 | — |
| NY | — | $11.03 | — |
| OH | — | $11.03 | — |
| OK | — | $11.03 | — |
| OR | — | $11.03 | — |
| PA | — | $11.03 | — |
| PR | — | $11.03 | — |
| RI | — | $11.03 | — |
| SC | — | $11.03 | — |
| SD | — | $11.03 | — |
| TN | — | $11.03 | — |
| TX | — | $11.03 | — |
| UT | — | $11.03 | — |
| VA | — | $11.03 | — |
| VI | — | $11.03 | — |
| VT | — | $11.03 | — |
| WA | — | $11.03 | — |
| WI | — | $11.03 | — |
| WV | — | $11.03 | — |
| WY | — | $11.03 | — |
How the Q4009 fee compares
| Measure | Value |
|---|---|
| Rank among 49 Q40 codes (lowest = 1) | 12 |
| Family fee range (average of state fees) | $2.68–$235.64 |
| Rural fee uplift | — |
Who bills Q4009 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 312 |
| Medicare beneficiaries | 717 |
| States with claims | 18 |
| Share of services in top 3 states (Maryland, Michigan, New York) | 44% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4009, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 918 | 797 | $9.27 | $7.22 |
| 2023 | 863 | 741 | $10.00 | $7.66 |
| 2024 | 888 | 717 | $10.20 | $7.87 |
States with the most Q4009 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Maryland | 158 | $7.86 |
| Michigan | 117 | $8.12 |
| New York | 70 | $8.16 |
| Florida | 66 | $8.03 |
| Texas | 50 | $7.62 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Anatomic Consideration |
| practitioner claims | 2 | Anatomic Consideration |
What changed for Q4009
- 2026-01-01: Average state fee rose 2.0%: $10.81 to $11.03
- 2001-07-01: Q4009 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code Q4009?
Q4009 is the HCPCS Level II code for cast supplies, short arm cast, adult (11 years +), plaster. Short descriptor: "Cast sup sht arm adult plstr".
How much does Medicare pay for Q4009?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $11.03. Rural fees can be higher.
Does Medicare cover Q4009?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for Q4009 change in 2026?
The average non-rural state fee moved from $10.81 in 2025 to $11.03 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of Q4009 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related Q40 codes
- Q4001 — Casting supplies, body cast adult, with or without head, plaster ($62.36–$62.36)
- Q4002 — Cast supplies, body cast adult, with or without head, fiberglass ($235.64–$235.64)
- Q4003 — Cast supplies, shoulder cast, adult (11 years +), plaster ($44.78–$44.78)
- Q4004 — Cast supplies, shoulder cast, adult (11 years +), fiberglass ($155.03–$155.03)
- Q4005 — Cast supplies, long arm cast, adult (11 years +), plaster ($16.51–$16.51)
- Q4006 — Cast supplies, long arm cast, adult (11 years +), fiberglass ($37.20–$37.20)
- Q4007 — Cast supplies, long arm cast, pediatric (0-10 years), plaster ($8.25–$8.25)
- Q4008 — Cast supplies, long arm cast, pediatric (0-10 years), fiberglass ($18.59–$18.59)
- Q4010 — Cast supplies, short arm cast, adult (11 years +), fiberglass ($24.80–$24.80)
- Q4011 — Cast supplies, short arm cast, pediatric (0-10 years), plaster ($5.50–$5.50)
- Q4012 — Cast supplies, short arm cast, pediatric (0-10 years), fiberglass ($12.43–$12.43)
- Q4013 — Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster ($20.07–$20.07)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under Q4009
- Watch Q4009 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4009
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.