Q4316 HCPCS code: Amchoplast, per square centimeter
Q4316 is the HCPCS Level II code for amchoplast, per square centimeter. In 2024 Medicare paid an average of $3,314.53 per service for Q4316 across 16,632 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. In 2024, about 36 clinicians billed Medicare for Q4316 for 138 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 | 2024-07-01 |
| Last action effective | 2024-07-01 |
Who bills Q4316 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 36 |
| Medicare beneficiaries | 138 |
| States with claims | 4 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for Q4316, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 16,632 | 138 | $4,160.08 | $3,314.53 |
States with the most Q4316 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Illinois | 9,235 | $3,319.76 |
| Michigan | 2,468 | $3,317.49 |
| New York | 1,810 | $3,320.24 |
| Arizona | 1,540 | $3,271.10 |
What changed for Q4316
- 2024-07-01: Q4316 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 Q4316?
Q4316 is the HCPCS Level II code for amchoplast, per square centimeter. Short descriptor: "Amchoplast, per sq cm".
How much does Medicare pay for Q4316?
In 2024, the average Medicare payment was $3,314.53 per service (average allowed $4,160.08).
Does Medicare cover Q4316?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Related Q43 codes
- Q4300 — Acesso tl, per square centimeter
- Q4301 — Activate matrix, per square centimeter
- Q4302 — Complete aca, per square centimeter
- Q4303 — Complete aa, per square centimeter
- Q4304 — Grafix plus, per square centimeter
- Q4305 — American amnion ac tri-layer, per square centimeter
- Q4306 — American amnion ac, per square centimeter
- Q4307 — American amnion, per square centimeter
- Q4308 — Sanopellis, per square centimeter
- Q4309 — Via matrix, per square centimeter
- Q4310 — Procenta, per 100 mg
- Q4311 — Acesso, per square centimeter
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 Q4316
- Watch Q4316 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for Q4316
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.