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Favorable Physician Business Model

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Payment Allowance for Medicare Part B

HCPCS Code: Q4204

Short Description: Membrane graft or wrap sq. cm

HCPCS Code Dosage: 1sq. cm

Payment Allowance: $2820/sq. cm

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Physician Friendly Business Model

IDENTIFY PATIENT

  • 4 weeks of conservative care
  • Maintain template/notes
  • Submit Verification of Insurance Request (VIR)
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PURCHASE

  • The week prior to treatment - submit PO (Next day delivery)
  • Treat Patient
  • Start billing event
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PAYMENT

  • 30 days net begins on delivery date
  • Repeat weekly/biweekly until wound successfully heals
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XWRAP® Part Number Description
XWO-60202 XWRAP® 2x2cm (Q4204)
XWO-60404 XWRAP® 4x4cm (Q4204)
XWO-60408 XWRAP® 4x8cm (Q4204)

Shipping Costs:
Shipping costs will be passed on to the customer at cost.