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
Wisconsin
Hospital Address Code Price Last Updated
River Falls Area Hospital , River Falls Q4100 $6 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh Q4100 $1,864 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q4100 $2,188 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee Q4100 $3,550 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q4100 $3,758 [source] 4 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, Q4100 $3,978 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau Q4100 $3,978 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q4100 $4,354 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers Q4100 $10,261 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q4100 $15,303 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee Q4100 $23,361 [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.