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
Michigan
Hospital Address Code Price Last Updated
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q4102 $6 [source] 4 years ago
Mclaren Port Huron 1221 Pine Grove Ave, Port Huron Q4102 $7 [source] 4 years ago
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q4102 $8 [source] 4 years ago
Up Health System – Marquette 580 West College Avenue, Marquette Q4102 $13 [source] 4 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint Q4102 $40 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q4102 $75 [source] 4 years ago
Botsford Continuing Care Corporation 21450 Archwood Cir, Farmington Q4102 $170 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre, Troy Q4102 $170 [source] 4 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak Q4102 $170 [source] 4 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy Q4102 $170 [source] 4 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak Q4102 $170 [source] 4 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak Q4102 $170 [source] 4 years ago
Oakwood Healthcare Inc Beaumont Service Center, Q4102 $170 [source] 4 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak Q4102 $170 [source] 4 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn Q4102 $170 [source] 4 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak Q4102 $170 [source] 4 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn Q4102 $170 [source] 4 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn Q4102 $170 [source] 4 years ago
Oakwood Healthcare, Inc. 33155 Annapolis St, Wayne Q4102 $170 [source] 4 years ago
Botsford General Hospital 28050 Grand River Ave, Farmington Q4102 $170 [source] 4 years ago
Oakwood Healthcare, Inc. 5450 Fort St, Trenton Q4102 $170 [source] 4 years ago
Oakwood Healthcare, Inc. 10000 Telegraph Rd, Taylor Q4102 $170 [source] 4 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak Q4102 $170 [source] 4 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak Q4102 $170 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q4102 $170 [source] 4 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak Q4102 $170 [source] 4 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer Q4102 $239 [source] 4 years ago
Mclaren Thumb Region 1100 S Van Dyke Rd, Bad Axe Q4102 $407 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren Q4102 $2,030 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4102 $2,330 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4102 $3,530 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4102 $3,960 [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 §180.