How much does Medicare pay for HCPCS Q4221?

Medicare allowed an average of $1751.50 per service and paid $1395.45 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1917.96, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code Q4221?

Amniowrap2, per square centimeter. It was billed 40,666 times to 455 Medicare beneficiaries by 19 providers in 2024.

Which specialty bills Q4221 most?

Nurse Practitioner, with 14,756 services from 9 clinicians. Next are Physician Assistant, Preventive Medicine, Family Practice.

HCPCS Q4221

Amniowrap2, per square centimeter

$1751.50Medicare-allowed amount per service, averaged across 40,666 services

Providers submitted

$1917.96

Asking price, not received

Medicare allowed

$1751.50

The fee schedule figure

Medicare paid

$1395.45

Balance is patient coinsurance

Services: 40,666
Beneficiaries: 455
Providers billing it: 19
Total allowed: $71,226,499

What Medicare pays for HCPCS Q4221

Across 40,666 services billed by 19 providers to 455 beneficiaries, Medicare allowed an average of $1751.50 per service. That is 89.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills Q4221

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	14,756	152	$1676.43	9
Physician Assistant	8,785	77	$1861.85	2
Preventive Medicine	5,858	17	$1897.03	1
Family Practice	3,419	19	$1565.36	1
General Practice	2,961	64	$1627.03	1
Dermatology	2,909	103	$1800.20	3
Plastic and Reconstructive Surgery	1,425	12	$1847.28	1
Podiatry	553	11	$1774.27	1

Q4221 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Washington	9,525	$1848.43	$1472.70	2
Arizona	6,720	$1680.93	$1339.08	3
Kentucky	5,858	$1897.03	$1511.46	1
Nevada	5,531	$1508.61	$1201.98	2
Illinois	4,228	$1613.86	$1285.84	2
Texas	2,028	$1771.94	$1411.62	1
Ohio	1,976	$1839.02	$1465.23	2
Colorado	1,835	$1853.88	$1477.08	1
Florida	1,425	$1847.28	$1471.82	1
Minnesota	633	$1863.46	$1484.71	1
South Carolina	553	$1774.27	$1413.64	1
Idaho	193	$1828.56	$1456.90	1
California	161	$1668.87	$1329.62	1

Related codes

Q4205Membrane graft or membrane wrap$1301.16
Q4271Complete ft, per square centimeter$1655.29
Q4275Esano aca, per square centimeter$2621.95
Q4262Dual layer impax membrane$1135.62
Q4276Orion, per square centimeter$1335.32
Q4238Derm-maxx, per square centimeter$1119.08
Q4282Cygnus dual, per square centimeter$773.66
Q4236Carepatch, per square centimeter$758.90
Q4277Woundplus membrane or e-graft$1738.38
Q4299Amnicore pro+$2369.06
Q4239Amnio-maxx or amnio-maxx lite$2395.07
Q4278Epieffect, per square centimeter$409.48

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.