Q4400 – Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
HCPCS Level II code · Q codes: Temporary Codes
HCPCS codeQ4400
- Long description
- Polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Short description
- Polygon3 per sq cm
- Pricing indicator
11Priced using national RVUs (Physician Fee Schedule)- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
O1EOther drugs- Added
- January 1, 2026
- Last change
- January 1, 2026 – No change
Frequently asked questions
What is HCPCS code Q4400?
Q4400 is a HCPCS Level II code for polygon3 membrane, per square centimeter (add-on, list separately in addition to primary procedure).
Does Medicare cover Q4400?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby Q codes
- Q4392 – Grafix duo, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4393 – Surgraft ac, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4394 – Surgraft aca, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4395 – Acelagraft, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4396 – Natalin, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4397 – Summit aaa, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4398 – Summit ac, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4399 – Summit fx, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4401 – Absolv3 membrane, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4402 – Xwrap 2.0, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4403 – Xwrap dual plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4404 – Xwrap hydro plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4405 – Xwrap fenestra plus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4406 – Xwrap fenestra, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4407 – Xwrap tribus, per square centimeter (add-on, list separately in addition to primary procedure)
- Q4408 – Xwrap hydro, per square centimeter (add-on, list separately in addition to primary procedure)
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.