Code: Q4102

Description:
Description: Oasis wound matrix, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
OASIS WND MATRX 11 SQCM
DRESSING OASIS ULTRA PORCINE SMALL INTESTINE SUBMUCOSA 3.5X3CM BIOLOGICAL 3
Oasis Wound Matrix,8213100015
DRESSING OASIS PORCINE SMALL INTESTINE SUBMUCOSA 3.5X3CM BIOLOGICAL WOUND
DRESSING OASIS PORCINE SMALL INTESTINE SUBMUCOSA 7X3CM BIOLOGICAL WOUND
HC OASIS WOUND MATRIX PER SQ CM
OASIS WOUND MATRIX FENESTRATED, PER SQ CM, 3 X 7CM PAD
OASIS WOUND MATRIX PER SQ CM
HC OASIS WOUND MATRX PER SQ CM
Related codes:
Code: Q4100
SKIN SUBSTITUTE NOS
Code: Q4101
APLIGRAF 44 SQ CM
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) $6 14
New Jersey (NJ) $10 1
Illinois (IL) $10 7
Hawaii (HI) $11 5
Kansas (KS) $20 4
Massachusetts (MA) $23 13
Wisconsin (WI) $23 21
Delaware (DE) $26 1
Mississippi (MS) $26 2
Maine (ME) $27 1
Iowa (IA) $29 2
Connecticut (CT) $35 3
Pennsylvania (PA) $35 3
North Dakota (ND) $38 2
Rhode Island (RI) $43 2
Nebraska (NE) $46 7
Washington (WA) $51 2
Arizona (AZ) $55 2
Virginia (VA) $61 2
Missouri (MO) $71 8
Georgia (GA) $117 14
Kentucky (KY) $128 5
Oklahoma (OK) $134 4
New Hampshire (NH) $207 5
Michigan (MI) $251 123
Alabama (AL) $252 3
California (CA) $260 32
Nevada (NV) $419 10
Tennessee (TN) $424 11
North Carolina (NC) $441 24
Indiana (IN) $570 24
South Carolina (SC) $627 6
District of Columbia (DC) $634 1
Ohio (OH) $661 10
West Virginia (WV) $714 3
Florida (FL) $838 96
Maryland (MD) $863 7
Texas (TX) $878 25
Louisiana (LA) $1,006 3
New York (NY) $1,084 1
Colorado (CO) $3,002 2

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.