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
Ohio
Hospital Address Code Price Last Updated
Euclid Hospital 18901 Lakeshore Blvd., Cleveland Q4100 $3,948 [source] 4 years ago
South Pointe Hospital 20000 Harvard Rd., Cleveland Q4100 $3,948 [source] 4 years ago
Hillcrest Hospital 6780 Mayfield Rd., Cleveland Q4100 $3,948 [source] 4 years ago
Cleveland Clinic Main Campus 9500 Euclid Ave, Cleveland Q4100 $3,950 [source] 4 years ago
Marymount Hospital 12300 Mccracken Road, Cleveland Q4100 $3,952 [source] 4 years ago
Medina Hospital 1000 E. Washington St., Medina Q4100 $4,935 [source] 4 years ago
Lutheran Hospital 1730 West 25Th Street, Cleveland Q4100 $5,922 [source] 4 years ago
Fairview Hospital 18101 Lorain Ave., Cleveland Q4100 $5,925 [source] 4 years ago
Akron General Lodi Hospital 225 Elyria St., Lodi Q4100 $10,448 [source] 4 years ago
Akron General 1 Akron General Ave., Akron Q4100 $10,448 [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.