Renati membrane, per square centimeter (add-on, list separately in addition to primary procedure)
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medicare pricing for Q4435
Physician Fee Schedule (CY 2026, RVU26D)
Status A: active, paid separately under the PFS if covered. National amounts: non-facility $127.26, facility $127.26 (total RVUs 3.81 / 3.81 × $33.4009 conversion factor; facility NA: rarely or never done in that setting). Work RVU 0.00, practice expense RVU 3.81 non-facility and 3.81 facility, malpractice RVU 0.00. Global period ZZZ. Qualifying APM participants are paid at a $33.5675 conversion factor.
Payer policies and prior authorization for Q4435
14 of 14 payer prior-auth lists that name Q4435 require prior authorization or set conditions: Blue Shield of California Promise Health Plan, CarePlus Health Plans, HealthSpring, Humana, Molina Healthcare of California, Passport by Molina Healthcare (Kentucky).
Q4435 appears in 11 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.