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
Tennessee
Hospital Address Code Price Last Updated
Saint Thomas River Park Hospital, Llc 120 Walnut Commons Ln Ste D, Cookeville Q4102 $23 [source] 4 years ago
Ascension Saint Thomas Stones River 324 Doolittle Rd, Woodbury Q4102 $23 [source] 4 years ago
Ascension Saint Thomas Dekalb 520 W Main St, Smithville Q4102 $23 [source] 4 years ago
Ascension Saint Thomas Highlands 401 Sewell Dr, Sparta Q4102 $23 [source] 4 years ago
Saint Thomas Hickman Hospital 1518 Highway 100, Centerville Q4102 $23 [source] 4 years ago
Riverview Regional Medical Center 158 Hospital Drive, Carthage Q4102 $86 [source] 4 years ago
Sumner Regional Medical Center 555 Hartsville Pike, Gallatin Q4102 $137 [source] 4 years ago
Trousdale Medical Center 500 Church Street, Hartsville Q4102 $455 [source] 4 years ago
Southern Tennessee Regional Health System - Winchester 185 Hospital Road, Winchester Q4102 $522 [source] 4 years ago
Starr Regional Medical Center - Athens 1114 West Madison Ave, Athens Q4102 $1,675 [source] 4 years ago
Starr Regional Medical Center - Etowah 886 Highway 411 North, Etowah Q4102 $1,675 [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.