Q4264 HCPCS code: Cocoon membrane, per square centimeter
Q4264 is the HCPCS Level II code for cocoon membrane, per square centimeter. In 2024 Medicare paid an average of $1,500.17 per service for Q4264 across 8,465 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. Medicare volume rose 249% from 2023 to 2024 (2,423 to 8,465 services). In 2024, about 5 clinicians billed Medicare for Q4264 for 34 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 | 2023-01-01 |
| Last action effective | 2023-01-01 |
Who bills Q4264 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 5 |
| Medicare beneficiaries | 34 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4264, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 2,423 | 13 | $1,630.07 | $1,298.75 |
| 2024 | 8,465 | 34 | $1,882.89 | $1,500.17 |
States with the most Q4264 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 7,945 | $1,455.66 |
What changed for Q4264
- 2023-01-01: Q4264 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 Q4264?
Q4264 is the HCPCS Level II code for cocoon membrane, per square centimeter. Short descriptor: "Cocoon membrane, per sq cm".
How much does Medicare pay for Q4264?
In 2024, the average Medicare payment was $1,500.17 per service (average allowed $1,882.89).
Does Medicare cover Q4264?
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 Q4264
- Watch Q4264 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4264
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.