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
Florida
Hospital Address Code Price Last Updated
Adventhealth Dade City 13100 Fort King Rd, Dade City Q4100 $44 [source] 4 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q4100 $74 [source] 4 years ago
Adventhealth Daytona Beach 301 Memorial Medical Pkwy, Daytona Beach Q4100 $720 [source] 4 years ago
Central Florida Regional Hospital 1401 West Seminole Blvd, Sanford Q4100 $1,334 [source] 4 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q4100 $2,472 [source] 4 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4100 $3,106 [source] 4 years ago
Coral Gables Hospital 3100 Douglas Rd., Miami Q4100 $4,090 [source] 4 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q4100 $4,444 [source] 4 years ago
Osceola Regional Medical Center 700 West Oak St, Kissimmee Q4100 $4,834 [source] 4 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q4100 $4,909 [source] 4 years ago
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q4100 $5,092 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4100 $5,648 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4100 $5,648 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4100 $5,648 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4100 $5,648 [source] 4 years ago
Cleveland Clinic Florida - Weston 2950 Cleveland Clinic Boulevard, Fort Lauderdale Q4100 $5,922 [source] 4 years ago
Palmetto General Hospital 2001 West 68Th St., Hialeah Q4100 $6,312 [source] 4 years ago
Orange Park Medical Center 2001 Kingsley Avenue, Orange Park Q4100 $6,930 [source] 4 years ago
Lake City Medical Center 340 Nw Commerce Dr, Lake City Q4100 $7,485 [source] 4 years ago
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q4100 $7,632 [source] 4 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q4100 $8,925 [source] 4 years ago
Highlands Regional Medical Center 3600 South Highlands Ave, Sebring Q4100 $8,925 [source] 4 years ago
West Florida Hospital 8383 N Davis Hwy, Pensacola Q4100 $9,075 [source] 4 years ago
Capital Regional Medical Center 2626 Capital Medical Blvd, Tallahassee Q4100 $9,367 [source] 4 years ago
Adventhealth Zephyrhills 7050 Gall Blvd, Zephyrhills Q4100 $10,868 [source] 4 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q4100 $11,411 [source] 4 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q4100 $13,484 [source] 4 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q4100 $13,484 [source] 4 years ago
Palms Of Pasadena Hospital 1501 Pasadena Ave, Saint Petersburg Q4100 $13,879 [source] 4 years ago
Gulf Coast Regional Medical Center 449 W 23Rd St, Panama City Q4100 $14,438 [source] 4 years ago
Adventist Health System/Sunbelt, Inc. 4001 W Linebaugh Ave, Tampa Q4100 $14,487 [source] 4 years ago
Florida Hospital Carrollwood 7171 N Dale Mabry Hwy, Tampa Q4100 $14,487 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4100 $14,487 [source] 4 years ago
Memorial Hospital 3625 University Blvd. S, Jacksonville Q4100 $14,648 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4100 $14,779 [source] 4 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q4100 $15,023 [source] 4 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q4100 $15,504 [source] 4 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q4100 $15,504 [source] 4 years ago
Largo Medical Center 201 14Th St Sw, Largo Q4100 $16,241 [source] 4 years ago
Memorial Hospital Of Tampa 2901 W. Swann Avenue, Tampa Q4100 $17,048 [source] 4 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q4100 $17,799 [source] 4 years ago
Adventhealth Lake Wales 410 South 11Th Street, Lake Wales Q4100 $18,404 [source] 4 years ago
Adventhealth Ocala 1500 Sw 1St Ave, Ocala Q4100 $18,404 [source] 4 years ago
Adventhealth Heart Of Florida 10987 Sheldon Rd Ste 100, Tampa Q4100 $18,404 [source] 4 years ago
Jfk Medical Center - North Campus 2201 45Th St, West Palm Beach Q4100 $19,250 [source] 4 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q4100 $20,237 [source] 4 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q4100 $20,237 [source] 4 years ago
North Florida Regional Medical Center 6500 W Newberry Rd, Gainesville Q4100 $20,625 [source] 4 years ago
Brandon Regional Hospital 119 Oakfield Dr, Brandon Q4100 $23,883 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4100 $28,433 [source] 4 years ago
Fort Walton Beach Medical Center 1000 Mar Walt Dr, Fort Walton Beach Q4100 $34,650 [source] 4 years ago
Palms West Hospital 13001 Southern Blvd, Loxahatchee Q4100 $36,365 [source] 4 years ago
Kendall Regional Medical Center 11750 Sw 40 St, Miami Q4100 $44,100 [source] 4 years ago
Ocala Health 1431 Sw 1St Ave, Ocala Q4100 $75,023 [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.