Q4295 HCPCS code: Amnio tri-core amniotic, per square centimeter
Q4295 is the HCPCS Level II code for amnio tri-core amniotic, per square centimeter. In 2024 Medicare paid an average of $1,544.30 per service for Q4295 across 81,371 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2024, about 286 clinicians billed Medicare for Q4295 for 1,142 beneficiaries; Florida, Oklahoma, Mississippi accounted for 66% 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 | 2024-01-01 |
| Last action effective | 2024-01-01 |
Who bills Q4295 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 286 |
| Medicare beneficiaries | 1,142 |
| States with claims | 17 |
| Share of services in top 3 states (Florida, Oklahoma, Mississippi) | 66% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4295, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 81,371 | 1,142 | $1,938.26 | $1,544.30 |
States with the most Q4295 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 31,352 | $1,551.14 |
| Oklahoma | 11,335 | $1,551.00 |
| Mississippi | 7,852 | $1,602.85 |
| Michigan | 4,478 | $1,404.54 |
| Massachusetts | 3,770 | $1,598.08 |
What changed for Q4295
- 2024-01-01: Q4295 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 Q4295?
Q4295 is the HCPCS Level II code for amnio tri-core amniotic, per square centimeter. Short descriptor: "Amnio tri-core, per sq cm".
How much does Medicare pay for Q4295?
In 2024, the average Medicare payment was $1,544.30 per service (average allowed $1,938.26).
Does Medicare cover Q4295?
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 Q4295
- Watch Q4295 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4295
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.