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See a sample rate comparisonHCPCS Q4264 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Temporary Codes Skin Substitutes and Biologicals |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for Q4264 |
National average reimbursement for HCPCS Q4264 by major payers:
$606.76
$2,836.65
$49.42
$2,766.06
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HCPCS Q4264
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newton Hospital, Inc., Newton Medical Center
Piedmont Newton Hospital Inc
$4,321.39Published rateDevon Daney
Aztec Urgent Care LLC
$2,781.00Published rateFloyd Healthcare Management Inc, Atrium Health Floyd Medical Center
Floyd Healthcare Management, Inc.
$2,781.00Published rateHospital Authority Of Valdosta And Lowndes County Georgia, South Georgia Medical Center
Hospital Authority Of Valdosta And Lowndes County Georgia
$2,781.00Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Grady Memorial Hospital Corporation
$2,363.85Published rate
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See a sample payer proposalHCPCS Q4264 vs. Other Skin Substitutes and Biologicals Codes
The HCPCS Q4264 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 Q4264 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 |
|---|---|---|
| Q4263-HCPCS | Moderate | Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure) |
| Q4264-HCPCS | Moderate | Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure) |
| Q4265-HCPCS | High | Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4264. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4264 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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