Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q4436-renati-ac-membrane-per-sq-cm
    Ask Trek AI about this page

    HCPCS Level II Q4436: Renati ac membrane, per square centimeter (add-on)

    HCPCS Level II code Q4436 describes billing for the Renati ac membrane charged per square centimeter as an add-on surgical biomaterial supply, intended for use in surgical procedures requiring acellular dermal/soft tissue membrane placement; the service is classified as a surgical supply/add-on item and is typically used in inpatient or outpatient surgical settings adjacent to the primary procedure.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

    Customize your policy alerts

    Sign up for hcpcs Q4436 policy alerts

    Get alerted when payer policies referencing Q4436 are released or updated.

    Monitor payer policy activity

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

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a middle-aged adult presenting to an outpatient ophthalmology or oculoplastic surgery practice with a full-thickness corneal defect or stromal loss after trauma, infectious keratitis, or failed prior graft, where an amniotic membrane substitute (Renati ac membrane) is required as an adjunct to primary repair. The clinical workflow begins with pre-procedure assessment including visual acuity, slit-lamp exam, and identification of wound size and location. In the operating room or procedure suite, the surgeon performs the primary procedure (for example, corneal patch graft, tectonic keratoplasty, or debridement with conjunctival flap) and then applies the Renati ac membrane sized per square centimeter as an add-on biologic membrane to promote epithelialization, reduce inflammation, and support tissue healing. Post-procedure care includes topical antibiotics and steroids per surgeon protocol, scheduled follow-up visits to assess membrane integration and epithelial closure, and documentation of membrane square centimeters used for billing Q4436 as an add-on to the primary procedure code.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    65272Repair of full-thickness corneal laceration, with or without tissue; single layerOften the primary procedure to which the Renati membrane Q4436 is added for coverage of additional biologic membrane material used to support the repair.
    65778Amniotic membrane for ocular surface reconstruction; graft, allograft (other than corneal or scleral graft)Procedures involving ocular surface reconstruction frequently include biologic membranes; Q4436 is billed per square centimeter as an add-on membrane supply when applicable.
    65785Conjunctival graft for corneal surface (eg, pterygium)When conjunctival grafting is performed for corneal surface disease, an adjunctive membrane may be applied and reported with Q4436 for membrane area used.
    65710Keratectomy (superficial) with or without scraping; single or multiple proceduresSuperficial keratectomy with adjunctive membrane placement for epithelial defects can be followed by billing Q4436 for membrane material.
    65720Corneal transplantation by lamellar grafting; partial-thicknessIn tectonic or lamellar grafts where adjunctive membranes are applied to promote epithelialization, Q4436 is billed in addition to the primary transplant CPT code.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    3PThe CPT Category II modifier -3P denotes a performance‑measure exclusion when a required quality action was not performed because of system‑level constraints. It is appended only to Category II…- When to apply: Use CPT Category II modifier 3P only with Category II (‘‘F’’) codes when a specific quality measure’s specifications allow a system‑level exclusion — append 3P to indicate the…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    53Modifier 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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    2PModifier -2P is a Category II performance‑measure exclusion appended to a CPT Category II (quality) code when the provider did not perform the measured action because of patient‑related reasons (for…- Use modifier 2P only with CPT Category II (performance‑measure) codes when a patient‑specific reason prevented performance of the measured action (for example, patient refusal, economic or social…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207W00000XOphthalmology PhysicianAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
    163W00000XRegistered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    3336C0002XClinic PharmacyA pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision o…
    229N00000XAnaplastologistAn anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, trau…
    207ZP0213XPediatric Pathology PhysicianA pediatric pathologist is expert in the laboratory diagnosis of diseases that occur during fetal growth, infancy and child development. The practice …
    385HR2050XRespite Care CampA camping facility that provides specialized respite care to individuals requiring enhanced services to enable them to remain in the community, (e.g.,…
    332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyAn Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy means a pharmacy operated by the Indian Health Service, an Indian tribe or tribal…

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    10 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV)blue cross blue shield - louisiana2026-09-15

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    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

    • More pages

    Frequently Asked Questions

    References

    1. 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. 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. 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.