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
Oklahoma
Hospital Address Code Price Last Updated
St. John Owasso 12451 E 100Th St N, Owasso Q4101 $29 [source] 4 years ago
St. John Medical Center 1923 S Utica Ave, Tulsa Q4101 $30 [source] 4 years ago
St John Sapulpa, Inc. 1004 E Bryan Ave, Sapulpa Q4101 $65 [source] 4 years ago
St. Mary’S Regional Medical Center 305 South 5Th Street, Enid Q4101 $4,294 [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.