Summary & Overview
HCPCS Q4306: American Amnion Allograft, Per Square Centimeter
HCPCS Level II code Q4306 identifies American amnion allograft priced and billed per square centimeter as an add-on supply used in wound care and surgical tissue repair. This designation matters nationally because biologic graft materials are increasingly used across specialties—especially wound care, plastic and reconstructive surgery, and orthopedics—and have distinct billing and reimbursement considerations when reported in addition to a primary procedure.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical role and typical sites of service, accompanied by an overview of common billing modifiers and payer considerations. The publication outlines benchmarks for add-on biologic material reporting, describes how Q4306 is used alongside primary surgical procedures, and highlights policy and coverage themes that affect national reimbursement and documentation practices.
The summary provides practical context for billing, coding, and revenue leaders seeking clarity on where Q4306 fits in the service line and clinical workflow. It also identifies gaps where data was not provided and points to areas—such as payer-specific coverage rules and fee schedules—where readers will need to consult payer documentation for implementation details.
Billing Code Overview
HCPCS Level II code Q4306 describes American amnion allograft, billed per square centimeter as an add-on, list separately in addition to primary procedure. The code identifies use of processed human amnion tissue applied to a patient to support wound healing or tissue repair.
Service Type: Amnion allograft application / biological graft material
Typical Site of Service: Operating room, outpatient surgical center, or wound care clinic
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a non-healing full-thickness diabetic foot ulcer of the plantar surface demonstrates failed conservative wound care after several weeks. The wound is debrided in the operating room under local or regional anesthesia, and the surgeon applies cryopreserved human amniotic membrane allograft to the wound bed to promote epithelialization and reduce inflammation. The billed item Q4306 represents the amnion allograft charged per square centimeter as an add-on to the primary wound procedure. Typical workflow includes preoperative wound assessment and measurement, sharp debridement, hemostasis, application and fixation of the graft, dressing placement, and documentation of graft size in square centimeters to support the Q4306 line item. Usual sites of service are outpatient hospital operating room, ambulatory surgery center, hospital inpatient OR when performed during admission, and office-based procedure rooms when allowed by payer policy. The service is provided by specialties such as podiatry, plastic surgery, vascular surgery, general surgery, and wound care specialists, working with nursing staff to document graft source, lot number, and exact surface area applied.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Placeholder for no modifier (not generally appended by CMS) |