Q4266 HCPCS code: Neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Q4266 is the HCPCS Level II code for neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure). In 2024 Medicare paid an average of $1,204.46 per service for Q4266 across 16,887 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2024, about 92 clinicians billed Medicare for Q4266 for 175 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | Q codes — Temporary codes |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 11 — Priced using national relative value units (Physician Fee Schedule) |
| BETOS category | O1E — Other drugs |
| Added | 2023-04-01 |
| Last action effective | 2026-01-01 |
Who bills Q4266 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 92 |
| Medicare beneficiaries | 175 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4266, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 16,887 | 175 | $1,511.72 | $1,204.46 |
States with the most Q4266 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Tennessee | 5,557 | $1,218.69 |
| Florida | 1,421 | $1,105.09 |
| Georgia | 916 | $1,219.66 |
What changed for Q4266
- January 2026: Descriptor revised (Was: Neostim membrane, per square centimeter)
- 2023-04-01: Q4266 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 Q4266?
Q4266 is the HCPCS Level II code for neostim membrane, per square centimeter (add-on, list separately in addition to primary procedure). Short descriptor: "Neostim per sq cm".
How much does Medicare pay for Q4266?
In 2024, the average Medicare payment was $1,204.46 per service (average allowed $1,511.72).
Does Medicare cover Q4266?
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 (add-on, list separately in addition to primary procedure)
- Q4201 — Matrion, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4202 — Keroxx (2.5g/cc), 1cc
- Q4203 — Derma-gide, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4204 — Xwrap, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4205 — Membrane graft or membrane wrap, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4206 — Fluid flow or fluid gf, 1 cc
- Q4207 — Carbon life, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4208 — Novafix, per square cenitmeter (add-on, list separately in addition to primary procedure)
- Q4209 — Surgraft, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4210 — Axolotl graft or axolotl dualgraft, per square centimeter
- Q4211 — Amnion bio or axobiomembrane, per square centimeter (add-on, list separately in addition to primary procedure)
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 Q4266
- Watch Q4266 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4266
Sources: CMS HCPCS Level II release October 2026; 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.