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
Indiana
Hospital Address Code Price Last Updated
Ascension St. Vincent Warrick 1116 Millis Ave, Boonville Q4100 $101 [source] 4 years ago
Ascension St. Vincent Hospital 2001 W 86Th St, Indianapolis Q4100 $101 [source] 4 years ago
Ascension Medical Group St. Vincent 301 Henry St, North Vernon Q4100 $101 [source] 4 years ago
Ascension St. Vincent Evansville 3700 Washington Ave, Evansville Q4100 $101 [source] 4 years ago
Ascension St. Vincent Williamsport 412 N Monroe St, Williamsport Q4100 $101 [source] 4 years ago
St Vincent Salem Hospital Inc 911 N Shelby St, Salem Q4100 $101 [source] 4 years ago
St. Vincent Mercy Hospital 1331 S A St, Elwood Q4100 $101 [source] 4 years ago
Ascension St. Vincent Dunn 1600 23Rd St, Bedford Q4100 $101 [source] 4 years ago
Ascension St. Vincent Randolph 473 E Greenville Ave, Winchester Q4100 $101 [source] 4 years ago
Ascension St. Vincent Carmel 13500 N Meridian St, Carmel Q4100 $101 [source] 4 years ago
Ascension St. Vincent Anderson 2015 Jackson St, Anderson Q4100 $101 [source] 4 years ago
Ascension St. Vincent Heart Center 10580 N Meridian St, Indianapolis Q4100 $101 [source] 4 years ago
St. Vincent Clay Hospital, Inc 1206 E National Ave, Brazil Q4100 $6,012 [source] 4 years ago
Ascension St Vincent Fishers 13861 Olio Road, Q4100 $6,012 [source] 4 years ago
Terre Haute Regional Hospital 3901 S 7Th St, Terre Haute Q4100 $14,287 [source] 4 years ago
Franciscan Health Indianapolis , Indianapolis Q4100 $20,545 [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.