Code: Q4101

Description:
Description: Apligraf, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
Apligraf 7.5 Cm
GRAFT APLIGRAF 7.5CM BOVINE COLLAGEN MATRIX HUMAN FIBROBLAST .75MM SKIN
Drsg Apligraf (free) Per Sq Cm
APLIGRAF 44CM PER SQ CM
SKIN GRAFT, APLIGRAF
APLIGRAF 44.2 PER SQCM
HC APLIGRAF PER SQ CM
APLIGRAF PER SQ CM
APLIGRAF N/MCARE 1 UNIT Q
Related codes:
Code: Q4100
SKIN SUBSTITUTE NOS
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
State Average # Hospitals In Database
Minnesota (MN) $14 15
Hawaii (HI) $31 4
Illinois (IL) $78 8
Connecticut (CT) $81 8
Rhode Island (RI) $83 2
Maine (ME) $84 5
Pennsylvania (PA) $89 2
Mississippi (MS) $100 3
Tennessee (TN) $107 9
Delaware (DE) $110 1
Wyoming (WY) $113 2
Washington (WA) $114 1
Nebraska (NE) $120 7
North Dakota (ND) $145 2
Georgia (GA) $189 14
Wisconsin (WI) $308 27
Michigan (MI) $483 126
Missouri (MO) $655 11
Indiana (IN) $713 23
Arizona (AZ) $720 5
Iowa (IA) $771 2
California (CA) $947 32
Massachusetts (MA) $956 13
Kansas (KS) $1,034 8
Oklahoma (OK) $1,104 4
South Carolina (SC) $1,110 4
Alabama (AL) $1,171 3
Maryland (MD) $1,686 11
Virginia (VA) $1,692 4
Kentucky (KY) $1,797 8
New Hampshire (NH) $1,839 6
Idaho (ID) $1,914 2
District of Columbia (DC) $2,286 2
North Carolina (NC) $2,487 29
New York (NY) $2,720 4
West Virginia (WV) $3,043 4
Louisiana (LA) $3,199 1
Texas (TX) $3,291 46
Colorado (CO) $3,494 3
Ohio (OH) $3,866 10
Florida (FL) $4,714 93
New Mexico (NM) $6,318 1
New Jersey (NJ) $7,911 2
Nevada (NV) $12,445 8
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.