Table of content for "Amnio bur dl mem per sq cm" (HCPCS Q4365)
General information on the “Q4365” code
HCPCS Code: Q4365
Long Description: Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Short Description: Amnio bur dl mem per sq cm
Original information is taken from Q4365 page
Pricing indicators
Pricing Indicator Code 1: 11 – Price established using national rvu's. Linked To The Physician Fee Schedule.
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
ASC Payment Group: YY
ASC Payment Group Effective Date: 20260101
Type of service
Berenson-Eggers Type of Service (BETOS): O1E – Other drugs
Type Of Service 1: 1 – Medical care
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20250401
Code Effective Date: 20260101
Action Code: N – No maintenance for this code