Q4205 HCPCS code: Membrane graft or membrane wrap, per square centimeter
Q4205 is the HCPCS Level II code for membrane graft or membrane wrap, per square centimeter. In 2024 Medicare paid an average of $1,037.66 per service for Q4205 across 1,107,302 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume rose 2974% from 2022 to 2024 (36,016 to 1,107,302 services). In 2024, about 2,027 clinicians billed Medicare for Q4205 for 10,503 beneficiaries; California, Texas, Florida accounted for 52% of services.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2019-10-01 |
| Last action effective | 2019-10-01 |
Who bills Q4205 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,027 |
| Medicare beneficiaries | 10,503 |
| States with claims | 38 |
| Share of services in top 3 states (California, Texas, Florida) | 52% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4205, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 36,016 | 571 | $348.52 | $278.23 |
| 2023 | 238,293 | 3,198 | $1,424.18 | $1,134.71 |
| 2024 | 1,107,302 | 10,503 | $1,302.47 | $1,037.66 |
States with the most Q4205 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 334,360 | $1,035.21 |
| Texas | 143,895 | $1,035.83 |
| Florida | 90,673 | $1,036.11 |
| Nevada | 65,271 | $1,052.62 |
| Arizona | 42,559 | $1,029.86 |
What changed for Q4205
- 2019-10-01: Q4205 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 Q4205?
Q4205 is the HCPCS Level II code for membrane graft or membrane wrap, per square centimeter. Short descriptor: "Membrane graft or wrap sq cm".
How much does Medicare pay for Q4205?
In 2024, the average Medicare payment was $1,037.66 per service (average allowed $1,302.47).
Does Medicare cover Q4205?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q42 codes
- Q4200 — Skin te, per square centimeter
- Q4201 — Matrion, per square centimeter
- Q4202 — Keroxx (2.5g/cc), 1cc
- Q4203 — Derma-gide, per square centimeter
- Q4204 — Xwrap, per square centimeter
- Q4206 — Fluid flow or fluid gf, 1 cc
- Q4208 — Novafix, per square cenitmeter
- Q4209 — Surgraft, per square centimeter
- Q4210 — Axolotl graft or axolotl dualgraft, per square centimeter
- Q4211 — Amnion bio or axobiomembrane, per square centimeter
- Q4212 — Allogen, per cc
- Q4213 — Ascent, 0.5 mg
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Next steps
- Run a reimbursement report for a device billed under Q4205
- Watch Q4205 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4205
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; 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.