How much does Medicare pay for HCPCS Q4290?

Medicare allowed an average of $1906.94 per service and paid $1519.35 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2028.23, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code Q4290?

Membrane wrap-hydro, per square centimeter. It was billed 33,873 times to 563 Medicare beneficiaries by 27 providers in 2024.

Which specialty bills Q4290 most?

Internal Medicine, with 13,331 services from 1 clinicians. Next are Nurse Practitioner, Dermatology, Podiatry.

HCPCS Q4290

Membrane wrap-hydro, per square centimeter

$1906.94Medicare-allowed amount per service, averaged across 33,873 services

Providers submitted

$2028.23

Asking price, not received

Medicare allowed

$1906.94

The fee schedule figure

Medicare paid

$1519.35

Balance is patient coinsurance

Services: 33,873
Beneficiaries: 563
Providers billing it: 27
Total allowed: $64,593,779

What Medicare pays for HCPCS Q4290

Across 33,873 services billed by 27 providers to 563 beneficiaries, Medicare allowed an average of $1906.94 per service. That is 60.2 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 Q4290

Specialty	Services	Beneficiaries	Avg allowed	Providers
Internal Medicine	13,331	119	$1929.62	1
Nurse Practitioner	12,260	199	$1869.71	15
Dermatology	4,649	154	$1924.38	5
Podiatry	2,366	29	$1929.62	2
Micrographic Dermatologic Surgery	448	25	$1929.62	1
Otolaryngology	357	12	$1929.62	1
General Surgery	342	12	$1929.62	1
Physician Assistant	120	13	$1850.97	1

Q4290 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
California	19,377	$1929.35	$1537.20	6
Mississippi	5,054	$1800.64	$1434.66	4
Florida	4,387	$1913.40	$1524.50	8
Texas	1,865	$1929.27	$1537.14	3
North Carolina	1,671	$1925.07	$1533.80	1
Arizona	551	$1921.11	$1530.64	2
Louisiana	480	$1893.07	$1508.30	1
Washington	368	$1929.62	$1537.42	1
Kansas	120	$1850.97	$1474.75	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.