Q4206 HCPCS code: Fluid flow or fluid gf, 1 cc
Q4206 is the HCPCS Level II code for fluid flow or fluid gf, 1 cc. In 2022 Medicare paid an average of $1,687.74 per service for Q4206 across 1,348 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2022, about 133 clinicians billed Medicare for Q4206 for 578 beneficiaries; South Carolina, Alabama, North Carolina accounted for 73% 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 Q4206 (2022)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 133 |
| Medicare beneficiaries | 578 |
| States with claims | 9 |
| Share of services in top 3 states (South Carolina, Alabama, North Carolina) | 73% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4206, 2022–2022
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,348 | 578 | $2,120.83 | $1,687.74 |
States with the most Q4206 services (2022)
| State | Services | Avg. paid |
|---|---|---|
| South Carolina | 517 | $1,688.47 |
| Alabama | 236 | $1,685.33 |
| North Carolina | 194 | $1,685.82 |
| Georgia | 93 | $1,625.50 |
| Tennessee | 80 | $1,687.82 |
Medicare policy articles for this code
- A58865: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A58883: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Palmetto GBA (MAC - Part A, MAC - Part B))
- A58893: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A59374: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A59434: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A59434: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A59764: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
- A59766: Billing and Coding: Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
What changed for Q4206
- 2019-10-01: Q4206 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 Q4206?
Q4206 is the HCPCS Level II code for fluid flow or fluid gf, 1 cc. Short descriptor: "Fluid flow or fluid gf 1 cc".
How much does Medicare pay for Q4206?
In 2022, the average Medicare payment was $1,687.74 per service (average allowed $2,120.83).
Does Medicare cover Q4206?
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
- Q4205 — Membrane graft or membrane wrap, per square centimeter
- 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
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 Q4206
- Watch Q4206 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4206
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.