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
California
Hospital Address Code Price Last Updated
Richmond Medical Center 901 Nevin Ave, Richmond Q4101 $111 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco Q4101 $111 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills Q4101 $111 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento Q4101 $111 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch Q4101 $111 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto Q4101 $111 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville Q4101 $111 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro Q4101 $111 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek Q4101 $111 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara Q4101 $111 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento Q4101 $111 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon Q4101 $111 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael Q4101 $111 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose Q4101 $111 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville Q4101 $111 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno Q4101 $111 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco Q4101 $111 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City Q4101 $111 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo Q4101 $111 [source] 4 years ago
Fountain Valley Regional Hospital 17100 Euclid At Warner, Fountain Valley Q4101 $211 [source] 4 years ago
Los Robles Regional Medical Center 215 West Janss Rd, Thousand Oaks Q4101 $450 [source] 4 years ago
Regional Medical Center Of San Jose 225 North Jackson Ave, San Jose Q4101 $665 [source] 4 years ago
Palmdale Regional Medical Center 38600 Medical Center Drive, Palmdale Q4101 $2,915 [source] 4 years ago
Rancho Springs Medical Center 25500 Medical Center Drive, Murrieta Q4101 $3,036 [source] 4 years ago
Inland Valley Medical Center 36485 Inland Valley Drive, Wildomar Q4101 $3,036 [source] 4 years ago
Temecula Valley Hospital 31700 Temecula Parkway, Temecula Q4101 $3,116 [source] 4 years ago
Corona Regional Medical Center 800 S. Main Street, Corona Q4101 $4,100 [source] 4 years ago
Sutter Delta Medical Center 3901 Lone Tree Way, Antioch Q4101 $4,507 [source] 4 years ago
Stanislaus Surgical Hospital 1421 Oakdale Rd, Modesto Q4101 $4,921 [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.