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
Michigan
Hospital Address Code Price Last Updated
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q4100 $25 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q4100 $26 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren Q4100 $35 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4100 $40 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4100 $61 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4100 $68 [source] 4 years ago
Beaumont - Farmington Hills 28050 Grand River Ave, Farmington Q4100 $105 [source] 4 years ago
Oakwood Healthcare Inc Beaumont Service Center, Q4100 $1,351 [source] 4 years ago
Oakwood Healthcare, Inc. 5450 Fort St, Trenton Q4100 $1,351 [source] 4 years ago
Oakwood Healthcare, Inc. 33155 Annapolis St, Wayne Q4100 $1,351 [source] 4 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn Q4100 $1,351 [source] 4 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn Q4100 $1,351 [source] 4 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn Q4100 $1,351 [source] 4 years ago
Mclaren Bay Special Care Hospital 3250 E Midland Rd Suite 1, Bay City Q4100 $1,431 [source] 4 years ago
Mclaren Bay Region 1900 Columbus Ave, Bay City Q4100 $1,431 [source] 4 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q4100 $1,675 [source] 4 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q4100 $1,675 [source] 4 years ago
Mclaren Thumb Region 1100 S Van Dyke Rd, Bad Axe Q4100 $5,897 [source] 4 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak Q4100 $6,225 [source] 4 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak Q4100 $6,225 [source] 4 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak Q4100 $6,225 [source] 4 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak Q4100 $6,225 [source] 4 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak Q4100 $6,225 [source] 4 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak Q4100 $6,225 [source] 4 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak Q4100 $6,225 [source] 4 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak Q4100 $6,225 [source] 4 years ago
Karmanos Cancer Institute 4100 John R St, Detroit Q4100 $12,235 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q4100 $16,542 [source] 4 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint Q4100 $22,570 [source] 4 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer Q4100 $39,487 [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.