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HCPCS Q4205 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Membrane graft or membrane wrap, per square centimeter
Key FactDetail
Service Type

Temporary Codes

Skin Substitutes and Biologicals

Complexity LevelHigh

National average reimbursement for HCPCS Q4205 by major payers:

bcbs

$1,031.97

uhc

$1,345.75

aetna

$1,375.92

cigna

$1,388.98

Preview provider-level rates for...
For billing codeHCPCS Q4205
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS Q4205

United
Q4205$1159.601003319278 - EARLE OKI MD PROF CORP481297352 - (NV) EARLE OKI MD PROF CORPNVObstetrics & Gynecology Physician (207V00000X)
United
Q4205$1680.001326018136 - ROBERT B STRIMLING MD & ASSOCIATES LLC1326018136 - (NV) ROBERT B STRIMLING MD & ASSOCIATES LLCNVDermatology Physician (207N00000X)
United
Q4205$1310.441942253075 - DANIEL L. BURKHEAD, MD LTD, INNOVATIVE PAIN CARE CENTER880510658 - (NV) DANIEL L. BURKHEAD, M.D. LTD. DBNVPain Medicine (Anesthesiology) Physician (207LP2900X)
United
Q4205$1159.601679546139 - JAMES EELLS205713759 - (NV) JAMES R EELLS, M.D., LTDNVInternal Medicine Physician (207R00000X)
United
Q4205$1159.601801367941 - JESSICA PHELPS611593402 - (NV) LAKE MEAD PEDIATRICS LLCNVFamily Nurse Practitioner (363LF0000X)
United
Q4205$1159.601679540306 - DANIAL LAIRD810896199NVPain Medicine (Anesthesiology) Physician (207LP2900X)
United
Q4205$1159.601508607029 - ROSA DUNN463084124 - ADVANCED SPINE AND POSTURENVFamily Nurse Practitioner (363LF0000X)
United
Q4205$1310.441336126721 - AARON PETERSON943302014NVVascular & Interventional Radiology Physician (2085R0204X)
United
Q4205$1309.051639308943 - ROBERT LIEBERMAN261814445 - (NV) THOMAS DERMATOLOGY, INC.NVSpecialist (174400000X)
United
Q4205$1159.601851701296 - MOHAMMAD HANIF882638571 - (CA) CRESCENT WOUND CARE INCNVHospitalist Physician (208M00000X)
United
Q4205$1572.541326079724 - SANFORD WHITE1326079724 - (NV) SANFORD WHITENVFamily Medicine Physician (207Q00000X)
United
Q4205$1310.441912413956 - JASON HUME200160881 - INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INCNVGerontology Nurse Practitioner (363LG0600X)
United
Q4205$1159.601205408713 - HANNAH WOYTEK880103557 - (NV) RENO ORTHOPEDIC CENTERNVPhysical Therapist (225100000X)
United
Q4205$1159.601598104960 - OMAR ASHRAF300502262NVInternal Medicine Physician (207R00000X)
United
Q4205$1511.641366899916 - SIERRA MUSICK880107050NVAnatomic Pathology & Clinical Pathology Physician (207ZP0102X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS Q4205 vs. Other Skin Substitutes and Biologicals Codes

The HCPCS Q4205 code is part of the Temporary Codes services used for Skin Substitutes and Biologicals. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS Q4205 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
Q4204-HCPCSHighXwrap, per square centimeter
Q4205-HCPCSHighMembrane graft or membrane wrap, per square centimeter
Q4206-HCPCSHighFluid flow or fluid GF, 1 cc

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4205. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the Q4205 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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