Code: Q4100

Description:
Description: Skin substitute, not otherwise specified
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
GRAFT SKIN KIT SPLIT THK
GRAFT SKN CRYO 75 SQ CM
GRAFT TIS ACTISHLD 4X4CM
GFT SKN MSH CRYO 464SQCM
GRFT SKN 2:1 MSH 800SQCM
SKIN SUBSTITUE NOS
PATCH DURAMATRIX-ONLAY COLLAGEN MATRIX 2X2IN DURAL CONFORMABLE RESORBABLE
PATCH DURAMATRIX-ONLAY COLLAGEN MATRIX 1X1IN DURAL CONFORMABLE RESORBABLE
PATCH DUREPAIR BOVINE COLLAGEN MATRIX 3X1IN DURAL RESORBABLE DURAPLASTY
Related codes:
Code: Q4101
APLIGRAF 44 SQ CM
Code: Q4102
OASIS WND MATRX 21 SQCM
Code: Q4103
OASIS BURN MATRIX 1SQCM
Code: Q4104
INTEGRA BMWD 1SQCM
Code: Q4105
INTEGRA DRTOMNIGF 1SQCM
Code: Q4106
DERMAGRAFT 37.5 SQCM
Code: Q4107
GRAFTJACKET 8 SQCM
Code: Q4108
INTEGRA MATRIX 25 SQCM
Code: Q4109
SKIN SUBSTITUTE TISSUEMEND PER SQ CM
State Average # Hospitals In Database
Kentucky (KY) $224 2
Maine (ME) $301 1
North Dakota (ND) $430 1
Colorado (CO) $744 2
Illinois (IL) $1,322 1
New Jersey (NJ) $2,065 2
District of Columbia (DC) $2,095 2
Indiana (IN) $3,657 24
Kansas (KS) $4,041 5
Oklahoma (OK) $4,182 1
Tennessee (TN) $4,706 3
West Virginia (WV) $4,716 1
Connecticut (CT) $5,046 3
Washington (WA) $5,085 3
Missouri (MO) $5,206 6
Maryland (MD) $5,228 9
Michigan (MI) $5,679 107
Ohio (OH) $5,742 10
Wisconsin (WI) $6,600 11
Massachusetts (MA) $7,570 14
Georgia (GA) $7,966 7
Louisiana (LA) $10,232 3
New Mexico (NM) $10,714 1
Texas (TX) $11,619 47
Iowa (IA) $12,993 3
Nebraska (NE) $13,193 11
Florida (FL) $13,978 86
California (CA) $14,086 48
Alabama (AL) $15,584 4
New York (NY) $16,780 3
North Carolina (NC) $17,209 26
Minnesota (MN) $17,756 13
Arizona (AZ) $21,030 1
Nevada (NV) $22,991 11
Idaho (ID) $26,092 2
New Hampshire (NH) $28,478 4
South Carolina (SC) $46,494 4
Virginia (VA) $51,527 4

ChargemasterDB by Joseph Paul Cohen
A database of US hospital prices based on data made available by the Centers for Medicare & Medicaid Services (CMS), HHS price transparancy rule 45 CFR ยง180.