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
Massachusetts
Hospital Address Code Price Last Updated
North Shore Medical Center Hospital 81 Highland Ave, Salem Q4101 $88 [source] 4 years ago
Brigham & Women Faulkner Hospital 1153 Centre St, Jamaica Plain Q4101 $88 [source] 4 years ago
Spaulding Rehab Hospital Boston 300 1St Ave, Charlestown Q4101 $88 [source] 4 years ago
Newton Wellesley Hospital 2014 Washington St, Newton Lower Falls Q4101 $88 [source] 4 years ago
Martha's Vineyard Hospital One Hospital Road, Oak Bluffs Q4101 $103 [source] 4 years ago
Spaulding Rehab Hospital Cape Cod 311 Service Rd, East Sandwich Q4101 $103 [source] 4 years ago
Cooley Dickinson Health Care 30 Locust St, Northampton Q4101 $103 [source] 4 years ago
Mclean Hospital 115 Mill St, Belmont Q4101 $103 [source] 4 years ago
Massachusetts Eye And Ear 243 Charles St, Boston Q4101 $103 [source] 4 years ago
Saint Vincent Hospital 123 Summer St., Worcester Q4101 $273 [source] 4 years ago
Brigham & Womens Hospital, Inc. 75 Francis St, Boston Q4101 $1,064 [source] 4 years ago
Spaulding Hospital Cambridge 1575 Cambridge St, Cambridge Q4101 $5,112 [source] 4 years ago
Nantucket Cottage Hospital 57 Prospect St, Nantucket Q4101 $5,112 [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.