HCPCS Code Details - Q4264

HCPCS Level II Code
Miscellaneous Services (Temporary Codes)
HCPCS Code Q4264
Description

Long description:
Cocoon membrane, per square centimeter (add-on, list separately in addition to primary procedure)

Short description:
Cocoon membrane, per sq cm

HCPCS Modifier1
HCPCS Pricing indicator 11 - Price established using national RVU's
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jan 01, 2026 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2026
Date added Added Jan 01, 2023
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - Q4264

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
October 1, 2025 - December 31, 2025 1 SQ CM 372.888 - - - - - -
Jul 1, 2025 - Sep 30, 2025 1 SQ CM 372.888 - - - - - -
April 1, 2025 - June 30, 2025 1 SQ CM 478.06 - - - - - -

See also

  • HCPCS Q4263 · Surgraft tl, per square centimeter (add-on, list separately in addition to primary procedure)

  • HCPCS Q4265 · Neostim tl, per square centimeter (add-on, list separately in addition to primary procedure)


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”