How much does Medicare pay for HCPCS Q4294?

Medicare allowed an average of $2211.76 per service and paid $1762.21 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2609.58, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code Q4294?

Amnio quad-core, per square centimeter. It was billed 24,158 times to 378 Medicare beneficiaries by 21 providers in 2024.

Which specialty bills Q4294 most?

Nurse Practitioner, with 6,311 services from 5 clinicians. Next are Podiatry, General Surgery, Plastic and Reconstructive Surgery.

HCPCS Q4294

Amnio quad-core, per square centimeter

$2211.76Medicare-allowed amount per service, averaged across 24,158 services

Providers submitted

$2609.58

Asking price, not received

Medicare allowed

$2211.76

The fee schedule figure

Medicare paid

$1762.21

Balance is patient coinsurance

Providers submitted an average of $2609.58 for this code and Medicare allowed $2211.76 — 1.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $1762.21 (80%); the rest is the patient’s coinsurance and deductible.

Services: 24,158
Beneficiaries: 378
Providers billing it: 21
Total allowed: $53,431,698

What Medicare pays for HCPCS Q4294

Across 24,158 services billed by 21 providers to 378 beneficiaries, Medicare allowed an average of $2211.76 per service. That is 63.9 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 Q4294

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	6,311	98	$2235.31	5
Podiatry	5,627	89	$2192.83	6
General Surgery	3,708	24	$2231.48	1
Plastic and Reconstructive Surgery	3,113	44	$2170.36	2
Dermatology	1,789	67	$2238.85	3
Emergency Medicine	1,312	29	$2207.19	2
Orthopedic Surgery	1,294	11	$2189.07	1
Family Practice	1,004	16	$2212.28	1

Q4294 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
Florida	6,334	$2189.69	$1744.63	5
California	3,782	$2242.54	$1786.74	2
Arizona	3,708	$2231.48	$1777.93	1
Texas	2,955	$2218.21	$1767.35	4
New Jersey	2,063	$2211.09	$1761.68	2
Delaware	1,617	$2238.45	$1783.48	1
Oklahoma	1,294	$2189.07	$1744.14	1
Georgia	878	$2171.36	$1730.03	1
Louisiana	773	$2203.73	$1755.81	1
Maryland	426	$2204.40	$1756.35	1
Iowa	252	$2057.84	$1639.58	1
Utah	76	$2242.54	$1786.74	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.