HCPCS Level II Q4188: AmnioArmor per Square Centimeter (Add-on)

Medicare pays $133 on average nationally for this procedure.

HCPCS Level II code Q4188 describes billing for AmnioArmor tissue product charged per square centimeter as an add-on item to be listed separately in addition to a primary surgical or wound-care procedure; the service represents provision of an amniotic membrane-derived biologic graft and is typically used in surgical wound coverage or soft-tissue repair settings, billed in operative or procedural sites such as ambulatory surgery centers, hospital operating rooms, or specialized wound care clinics.

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HCPCS Level II Q4188: AmnioArmor per Square Centimeter (Add-on)

Medicare pays $133 on average nationally for this procedure.

Customize your policy alerts

Sign up for hcpcs Q4188 policy alerts

Get alerted when payer policies referencing Q4188 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting with a complex, non-healing surgical wound or full-thickness soft tissue defect after debridement or excision (for example, chronic diabetic foot ulcer, non-healing venous stasis ulcer, or a post-traumatic soft tissue defect). The treating clinician (commonly a wound care surgeon, plastic surgeon, or podiatrist) performs operative wound bed preparation, including debridement and hemostasis, followed by application of an amniotic membrane product billed as Q4188 measured and reported per square centimeter as an add-on supply item.

Workflow steps:

Pre-procedure evaluation by the surgeon or wound care specialist with documentation of wound size, depth, vascular status, infection status, and prior treatments.
Operating room or procedure suite preparation with appropriate anesthesia (local, regional, or monitored sedation) and sterile field.
Sharp surgical debridement and hemostasis; irrigation and assessment of wound base and adjacent tissue.
Application of Amnioarmor product cut to size; quantification in square centimeters documented in the operative note and supply records for billing Q4188 as an add-on to the primary procedure.
Securement of the graft/membrane and dressing application; post-procedure wound care instructions and follow-up arranged for graft take assessment and dressing changes.
Documentation must tie the use of Q4188 to the primary surgical or wound procedure code, include the exact square-centimeter amount used, and note clinical rationale (e.g., to promote re-epithelialization and modulate inflammation).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, muscle and/or fascia (first 20 sq cm or less)	Commonly performed prior to application of an amniotic membrane to prepare the wound bed.
`15271`	Placement of biologic or synthetic skin substitute graft (first 50 sq cm)	CPT for placement of skin substitutes; `Q4188` is billed as an add-on supply for an amniotic product used in conjunction.
`97602`	Debridement (e.g., wound cleansing, selective debridement without anesthetic)	Non-surgical debridement code used in clinic before definitive operative application of biologic grafts.
`15999`	Unlisted skin and subcutaneous tissue procedure	Used when a skin substitute placement does not map to a specific CPT; `Q4188` may be reported alongside when applicable.
`15275`	Application of skin substitute to trunk, arms, legs; first 100 sq cm	Used for larger graft placements where amniotic membrane is part of the reconstructive strategy.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
207SG0207X	Medical Biochemical Genetics	A medical biochemical geneticist specializes in the diagnosis, evaluation, prevention, and treatment of patients with biochemical genetic disorders, d…
207QD0401X	Diabetology (Family Medicine) Physician	A family medicine physician who specializes in diagnosis and management of type 1, type 2, gestational, and atypical diabetes; diabetes complications;…
246R00000X	Pathology Technician	An individual with knowledge of specific techniques and instruments who performs all of the routine tests in a medical laboratory and who has the abil…
224ZR0403X	Driving and Community Mobility Occupational Therapy Assistant	Occupational therapy assistants contribute to the completion of an individualized occupational therapy driving and community mobility evaluation by ad…

Related ICD-10-CM Codes

17 rows

ICD-10-CM Code	Description
H02.831	Dermatochalasis of right upper eyelid
H02.832	Dermatochalasis of right lower eyelid
H02.833	Dermatochalasis of right eye, unspecified eyelid
H04.121	Dry eye syndrome of right lacrimal gland
H04.122	Dry eye syndrome of left lacrimal gland
H10.9	Unspecified conjunctivitis
H11.32	Conjunctival hemorrhage, left eye
H16.211	Exposure keratoconjunctivitis, right eye
H16.221	Keratoconjunctivitis sicca, not specified as Sjogren's, right eye
H16.9	Unspecified keratitis

Showing 1–10 of 17

Related Payer Policy Updates

Specialty: Infectious Disease1 / 3

10 rows

Policy	Payer	Effective Date
B-Hemolytic Streptococcus Testing	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays	Oscar Health	2026-10-01
Hepatitis Testing (A, B, C, D) Coverage Criteria	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Pathogen Panel Testing	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Vector-Borne Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV)	blue cross blue shield - louisiana	2026-09-15

HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

HCPCS Level II Q0035: Cardiokymography

HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

HCPCS Q0092: Set-up Portable X-ray Equipment

Showing 1–10 of 629

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Workflow steps:

Pre-procedure evaluation by the surgeon or wound care specialist with documentation of wound size, depth, vascular status, infection status, and prior treatments.
Operating room or procedure suite preparation with appropriate anesthesia (local, regional, or monitored sedation) and sterile field.
Sharp surgical debridement and hemostasis; irrigation and assessment of wound base and adjacent tissue.
Application of Amnioarmor product cut to size; quantification in square centimeters documented in the operative note and supply records for billing Q4188 as an add-on to the primary procedure.
Securement of the graft/membrane and dressing application; post-procedure wound care instructions and follow-up arranged for graft take assessment and dressing changes.
Documentation must tie the use of Q4188 to the primary surgical or wound procedure code, include the exact square-centimeter amount used, and note clinical rationale (e.g., to promote re-epithelialization and modulate inflammation).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, muscle and/or fascia (first 20 sq cm or less)	Commonly performed prior to application of an amniotic membrane to prepare the wound bed.
`15271`	Placement of biologic or synthetic skin substitute graft (first 50 sq cm)	CPT for placement of skin substitutes; `Q4188` is billed as an add-on supply for an amniotic product used in conjunction.
`97602`	Debridement (e.g., wound cleansing, selective debridement without anesthetic)	Non-surgical debridement code used in clinic before definitive operative application of biologic grafts.
`15999`	Unlisted skin and subcutaneous tissue procedure	Used when a skin substitute placement does not map to a specific CPT; `Q4188` may be reported alongside when applicable.
`15275`	Application of skin substitute to trunk, arms, legs; first 100 sq cm	Used for larger graft placements where amniotic membrane is part of the reconstructive strategy.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…	- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
208000000X	Pediatrics Physician	A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
367500000X	Certified Registered Nurse Anesthetist	(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
363A00000X	Physician Assistant	A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
207SG0207X	Medical Biochemical Genetics	A medical biochemical geneticist specializes in the diagnosis, evaluation, prevention, and treatment of patients with biochemical genetic disorders, d…
207QD0401X	Diabetology (Family Medicine) Physician	A family medicine physician who specializes in diagnosis and management of type 1, type 2, gestational, and atypical diabetes; diabetes complications;…
246R00000X	Pathology Technician	An individual with knowledge of specific techniques and instruments who performs all of the routine tests in a medical laboratory and who has the abil…
224ZR0403X	Driving and Community Mobility Occupational Therapy Assistant	Occupational therapy assistants contribute to the completion of an individualized occupational therapy driving and community mobility evaluation by ad…

Related ICD-10-CM Codes

17 rows

ICD-10-CM Code	Description
H02.831	Dermatochalasis of right upper eyelid
H02.832	Dermatochalasis of right lower eyelid
H02.833	Dermatochalasis of right eye, unspecified eyelid
H04.121	Dry eye syndrome of right lacrimal gland
H04.122	Dry eye syndrome of left lacrimal gland
H10.9	Unspecified conjunctivitis
H11.32	Conjunctival hemorrhage, left eye
H16.211	Exposure keratoconjunctivitis, right eye
H16.221	Keratoconjunctivitis sicca, not specified as Sjogren's, right eye
H16.9	Unspecified keratitis

Showing 1–10 of 17

Related Payer Policy Updates

Specialty: Infectious Disease1 / 3

10 rows

Policy	Payer	Effective Date
B-Hemolytic Streptococcus Testing	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays	Oscar Health	2026-10-01
Hepatitis Testing (A, B, C, D) Coverage Criteria	Oscar Health	2026-10-01
Lyme Disease Testing Coverage Criteria	Oscar Health	2026-10-01
Pathogen Panel Testing	Oscar Health	2026-10-01
Diagnostic Testing of Common Sexually Transmitted Infections	Oscar Health	2026-10-01
Coronavirus Testing in the Outpatient Setting	Oscar Health	2026-10-01
Testing for Vector-Borne Infections	Oscar Health	2026-10-01
Testing for Diagnosis of Active or Latent Tuberculosis	Oscar Health	2026-10-01
Human Immunodeficiency Virus (HIV)	blue cross blue shield - louisiana	2026-09-15

HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

HCPCS Level II Q0035: Cardiokymography

HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

HCPCS Q0092: Set-up Portable X-ray Equipment

Showing 1–10 of 629

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS Level II Q4188: AmnioArmor per Square Centimeter (Add-on)

Sign up for hcpcs Q4188 policy alerts

OpenPayer

HCPCS Level II Q4188: AmnioArmor per Square Centimeter (Add-on)

Sign up for hcpcs Q4188 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

References

HCPCS Level II Q4188: AmnioArmor per Square Centimeter (Add-on)

Sign up for hcpcs Q4188 policy alerts

HCPCS Level II Q4188: AmnioArmor per Square Centimeter (Add-on)

Sign up for hcpcs Q4188 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code Q4188 represent and how is it reported?

What documentation elements are required when billing Q4188?

With which primary procedure codes is Q4188 commonly reported?

What clinical situations and providers commonly use Q4188?

Which payers are referenced for coverage and where should I confirm detailed reimbursement policy?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related ICD-10-CM Codes

Related Payer Policy Updates

Related Codes

What does HCPCS code Q4188 represent and how is it reported?

What documentation elements are required when billing Q4188?

With which primary procedure codes is Q4188 commonly reported?

What clinical situations and providers commonly use Q4188?

Which payers are referenced for coverage and where should I confirm detailed reimbursement policy?

References