Q4290 HCPCS code: Membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure)
Q4290 is the HCPCS Level II code for membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure). In 2024 Medicare paid an average of $1,514.20 per service for Q4290 across 162,100 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2024, about 471 clinicians billed Medicare for Q4290 for 1,804 beneficiaries; California, Mississippi, Florida accounted for 56% of services.
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 | 2024-01-01 |
| Last action effective | 2026-01-01 |
Who bills Q4290 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 471 |
| Medicare beneficiaries | 1,804 |
| States with claims | 18 |
| Share of services in top 3 states (California, Mississippi, Florida) | 56% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4290, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 162,100 | 1,804 | $1,900.48 | $1,514.20 |
States with the most Q4290 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 40,724 | $1,534.69 |
| Mississippi | 25,857 | $1,500.20 |
| Florida | 19,763 | $1,486.11 |
| Texas | 18,156 | $1,524.85 |
| Arizona | 8,742 | $1,516.04 |
What changed for Q4290
- January 2026: Descriptor revised (Was: Membrane wrap-hydro, per square centimeter)
- 2024-01-01: Q4290 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 Q4290?
Q4290 is the HCPCS Level II code for membrane wrap-hydro, per square centimeter (add-on, list separately in addition to primary procedure). Short descriptor: "Membrane wrap hydr per sq cm".
How much does Medicare pay for Q4290?
In 2024, the average Medicare payment was $1,514.20 per service (average allowed $1,900.48).
Does Medicare cover Q4290?
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)
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Next steps
- Run a reimbursement report for a device billed under Q4290
- Watch Q4290 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4290
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.