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
California
Hospital Address Code Price Last Updated
Corona Regional Medical Center 800 S. Main Street, Corona Q4100 $765 [source] 4 years ago
Memorial Hospital Los Banos 520 W I St, Los Banos Q4100 $1,870 [source] 4 years ago
Sutter Santa Rosa Regional Hospital 30 Mark West Springs Rd, Santa Rosa Q4100 $2,132 [source] 4 years ago
Temecula Valley Hospital 31700 Temecula Parkway, Temecula Q4100 $2,143 [source] 4 years ago
Sutter Tracy Community Hospital 1420 N Tracy Blvd, Tracy Q4100 $2,205 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo Q4100 $2,740 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City Q4100 $2,740 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon Q4100 $2,740 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond Q4100 $2,740 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento Q4100 $2,740 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara Q4100 $2,740 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek Q4100 $2,740 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro Q4100 $2,740 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville Q4100 $2,740 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto Q4100 $2,740 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch Q4100 $2,740 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento Q4100 $2,740 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills Q4100 $2,740 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco Q4100 $2,740 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose Q4100 $2,740 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael Q4100 $2,740 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville Q4100 $2,740 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno Q4100 $2,740 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco Q4100 $2,740 [source] 4 years ago
Rancho Springs Medical Center 25500 Medical Center Drive, Murrieta Q4100 $3,024 [source] 4 years ago
Inland Valley Medical Center 36485 Inland Valley Drive, Wildomar Q4100 $3,024 [source] 4 years ago
Sutter Roseville Medical Center 1 Medical Plaza Dr, Roseville Q4100 $4,132 [source] 4 years ago
Sutter Auburn Faith Hospital 11815 Education St, Auburn Q4100 $4,132 [source] 4 years ago
Palmdale Regional Medical Center 38600 Medical Center Drive, Palmdale Q4100 $4,273 [source] 4 years ago
Fountain Valley Regional Hospital 17100 Euclid At Warner, Fountain Valley Q4100 $4,772 [source] 4 years ago
Sutter Solano Medical Center 300 Hospital Dr, Vallejo Q4100 $6,417 [source] 4 years ago
Sutter Medical Center Of Sacramento 2825 Capitol Avenue, Sacramento Q4100 $6,615 [source] 4 years ago
California Pacific Medical Center - Davies Campus 45 Castro St, San Francisco Q4100 $7,035 [source] 4 years ago
El Camino Hospital 2500 Grant Rd, Mountain View Q4100 $7,788 [source] 4 years ago
Sutter Delta Medical Center 3901 Lone Tree Way, Antioch Q4100 $8,203 [source] 4 years ago
Stanislaus Surgical Hospital 1421 Oakdale Rd, Modesto Q4100 $8,735 [source] 4 years ago
Sutter Coast Hospital 800 E Washington Blvd, Crescent City Q4100 $9,315 [source] 4 years ago
Eden Medical Center 20103 Lake Chabot Road, Castro Valley Q4100 $12,168 [source] 4 years ago
Mills-Peninsula Medical Center 1501 Trousdale Dr, Burlingame Q4100 $15,385 [source] 4 years ago
Regional Medical Center Of San Jose 225 North Jackson Ave, San Jose Q4100 $34,109 [source] 4 years ago
Sutter Davis Hospital 2000 Sutter Pl, Davis Q4100 $41,643 [source] 4 years ago
Doctors Medical Center Of Modesto 1441 Florida Ave., Modesto Q4100 $49,603 [source] 4 years ago
West Hills Hospital 7300 Medical Center Dr, West Hills Q4100 $73,862 [source] 4 years ago
Los Robles Regional Medical Center 215 West Janss Rd, Thousand Oaks Q4100 $100,000 [source] 4 years ago

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.