Q4369 — Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)
Q4369 is a HCPCS Level II code for amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure). It belongs to the Temporary Codes section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusA
Active code. Paid separately under the physician fee schedule.
- Work RVU
- 0.00
- PE (non-facility)
- 3.81
- PE (facility)
- 3.81
- Malpractice RVU
- 0.00
Global period: ZZZ
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The CMS record for Q4369
- Long descriptor
- Amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure)
- Short descriptor
- Amnioplast 3 per sq cm
- Added
- July 1, 2025
- BETOS
- O1E
- Pricing indicator
- 11 — Physician fee schedule
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Price established using national RVUs.
Codes adjacent to Q4369
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q4369 is not quite right, the correct code is very often within a few positions of it.
- Q4361Epixpress, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4362Cygnus disk, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4363Amnio burgeon membrane and hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4364Amnio burgeon xplus membrane and xplus hydromembrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4365Amnio burgeon dual-layer membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4366Dual layer amnio burgeon x-membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4367Amniocore sl, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4368Amchothick, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4370Aeroguard, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4371Neoguard, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4372Amchoplast excel, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4373Membrane wrap lite, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4375Duograft ac, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4376Duograft aa, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4377Trigraft ft, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4378Renew ft matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Questions about Q4369
What is HCPCS code Q4369?
Q4369 is a HCPCS Level II code for amnioplast 3, per square centimeter (add-on, list separately in addition to primary procedure). It sits in the Temporary Codes section.
Does Medicare cover Q4369?
The CMS HCPCS file marks Q4369 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is Q4369 paid under the physician fee schedule?
Q4369 carries PFS status code A. Active code. Paid separately under the physician fee schedule.