Q4253 HCPCS code: Zenith amniotic membrane, per square centimeter
Q4253 is the HCPCS Level II code for zenith amniotic membrane, per square centimeter. In 2024 Medicare paid an average of $206.38 per service for Q4253 across 22,911 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume fell 96% from 2022 to 2024 (521,771 to 22,911 services). In 2024, about 119 clinicians billed Medicare for Q4253 for 120 beneficiaries.
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 | 2021-10-01 |
| Last action effective | 2021-10-01 |
Who bills Q4253 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 119 |
| Medicare beneficiaries | 120 |
| States with claims | 4 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4253, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 521,771 | 4,124 | $897.25 | $715.12 |
| 2023 | 414,394 | 3,487 | $802.69 | $639.46 |
| 2024 | 22,911 | 120 | $259.05 | $206.38 |
States with the most Q4253 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Virginia | 4,670 | $188.30 |
| Maryland | 2,628 | $199.29 |
| Florida | 2,351 | $201.83 |
| New York | 1,044 | $201.47 |
What changed for Q4253
- 2021-10-01: Q4253 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 Q4253?
Q4253 is the HCPCS Level II code for zenith amniotic membrane, per square centimeter. Short descriptor: "Zenith amniotic membrane psc".
How much does Medicare pay for Q4253?
In 2024, the average Medicare payment was $206.38 per service (average allowed $259.05).
Does Medicare cover Q4253?
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
- 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
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 Q4253
- Watch Q4253 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4253
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.