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
Texas
Hospital Address Code Price Last Updated
Ascension Providence 6901 Medical Pkwy, Woodway Q4102 $26 [source] 4 years ago
Valley Baptist Medical Center 1040 West Jefferson, Brownsville Q4102 $26 [source] 4 years ago
Adventhealth Central Texas 2201 Clear Creek Rd, Killeen Q4102 $32 [source] 4 years ago
Adventhealth Rollins Brook 608 N Key Ave, Lampasas Q4102 $39 [source] 4 years ago
Rio Grande Regional Hospital 101 East Ridge Road, Mcallen Q4102 $44 [source] 4 years ago
Medical City Fort Worth 900 8Th Ave, Fort Worth Q4102 $84 [source] 4 years ago
Texas Health Huguley 11801 South Fwy, Burleson Q4102 $88 [source] 4 years ago
Doctors Hospital Of Laredo 10700 Mcpherson Road, Laredo Q4102 $118 [source] 4 years ago
Northwest Texas Healthcare System 1501 S. Coulter, Amarillo Q4102 $129 [source] 4 years ago
Medical City Dallas 13155 Noel Rd. Suite 200, Dallas Q4102 $144 [source] 4 years ago
Hca Houston Healthcare 3737 Buffalo Speedway Suite 140, Houston Q4102 $156 [source] 4 years ago
Texoma Medical Center 5016 South Us Highway 75, Denison Q4102 $206 [source] 4 years ago
Medical City Frisco 5500 Frisco Square Blvd, Frisco Q4102 $217 [source] 4 years ago
Ennis Regional Medical Center 2201 West Lampasas, Waxahachie Q4102 $543 [source] 4 years ago
Medical City Denton 3535 S Interstate 35, Corinth Q4102 $576 [source] 4 years ago
Palestine Regional Medical Center 2900 South Loop 256, Palestine Q4102 $852 [source] 4 years ago
Fort Duncan Regional Medical Center 3333 N. Foster Maldonado Blvd., Eagle Pass Q4102 $1,074 [source] 4 years ago
Medical City Las Colinas 6800 N Macarthur Blvd, Irving Q4102 $1,260 [source] 4 years ago
Medical City Arlington 3301 Matlock Rd, Arlington Q4102 $2,638 [source] 4 years ago
South Texas Health System Heart 1900 South D Street, Mcallen Q4102 $3,377 [source] 4 years ago
South Texas Health System Children’s 1102 W. Trenton Road, Edinburg Q4102 $3,377 [source] 4 years ago
South Texas Health System Mcallen 301 W. Expressway 83, Mcallen Q4102 $3,377 [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.