HCPCS Q4205 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Temporary Codes • Skin Substitutes and Biologicals |
| Complexity Level | High |
National average reimbursement for HCPCS Q4205 by major payers:

$1,031.97

$1,345.75

$1,375.92

$1,388.98
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS Q4205 | ||||||
United | Q4205 | $1159.60 | 1003319278 - EARLE OKI MD PROF CORP | 481297352 - (NV) EARLE OKI MD PROF CORP | NV | Obstetrics & Gynecology Physician (207V00000X) |
United | Q4205 | $1680.00 | 1326018136 - ROBERT B STRIMLING MD & ASSOCIATES LLC | 1326018136 - (NV) ROBERT B STRIMLING MD & ASSOCIATES LLC | NV | Dermatology Physician (207N00000X) |
United | Q4205 | $1310.44 | 1942253075 - DANIEL L. BURKHEAD, MD LTD, INNOVATIVE PAIN CARE CENTER | 880510658 - (NV) DANIEL L. BURKHEAD, M.D. LTD. DB | NV | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | Q4205 | $1159.60 | 1679546139 - JAMES EELLS | 205713759 - (NV) JAMES R EELLS, M.D., LTD | NV | Internal Medicine Physician (207R00000X) |
United | Q4205 | $1159.60 | 1801367941 - JESSICA PHELPS | 611593402 - (NV) LAKE MEAD PEDIATRICS LLC | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4205 | $1159.60 | 1679540306 - DANIAL LAIRD | 810896199 | NV | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | Q4205 | $1159.60 | 1508607029 - ROSA DUNN | 463084124 - ADVANCED SPINE AND POSTURE | NV | Family Nurse Practitioner (363LF0000X) |
United | Q4205 | $1310.44 | 1336126721 - AARON PETERSON | 943302014 | NV | Vascular & Interventional Radiology Physician (2085R0204X) |
United | Q4205 | $1309.05 | 1639308943 - ROBERT LIEBERMAN | 261814445 - (NV) THOMAS DERMATOLOGY, INC. | NV | Specialist (174400000X) |
United | Q4205 | $1159.60 | 1851701296 - MOHAMMAD HANIF | 882638571 - (CA) CRESCENT WOUND CARE INC | NV | Hospitalist Physician (208M00000X) |
United | Q4205 | $1572.54 | 1326079724 - SANFORD WHITE | 1326079724 - (NV) SANFORD WHITE | NV | Family Medicine Physician (207Q00000X) |
United | Q4205 | $1310.44 | 1912413956 - JASON HUME | 200160881 - INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC | NV | Gerontology Nurse Practitioner (363LG0600X) |
United | Q4205 | $1159.60 | 1205408713 - HANNAH WOYTEK | 880103557 - (NV) RENO ORTHOPEDIC CENTER | NV | Physical Therapist (225100000X) |
United | Q4205 | $1159.60 | 1598104960 - OMAR ASHRAF | 300502262 | NV | Internal Medicine Physician (207R00000X) |
United | Q4205 | $1511.64 | 1366899916 - SIERRA MUSICK | 880107050 | NV | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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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.
| Code | Complexity | Description |
|---|---|---|
| Q4204-HCPCS | High | Xwrap, per square centimeter |
| Q4205-HCPCS | High | Membrane graft or membrane wrap, per square centimeter |
| Q4206-HCPCS | High | Fluid 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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