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
Wisconsin
Hospital Address Code Price Last Updated
River Falls Area Hospital , River Falls Q4102 $2 [source] 4 years ago
Howard Young Medical Center Inc Of Woodruff Wisconsin 240 Maple Street, Woodruff Q4102 $5 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau Q4102 $8 [source] 4 years ago
Aspirus Riverview Hospital 410 Dewey St, Wisconsin Rapids Q4102 $8 [source] 4 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, Q4102 $8 [source] 4 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton Q4102 $16 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington Q4102 $27 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q4102 $27 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay Q4102 $27 [source] 4 years ago
Aurora Medical Center Of Manitowoc County 5000 Memorial Dr, Two Rivers Q4102 $27 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q4102 $27 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette Q4102 $27 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q4102 $27 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee Q4102 $27 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford Q4102 $27 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh Q4102 $27 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton Q4102 $27 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q4102 $27 [source] 4 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand Q4102 $34 [source] 4 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee Q4102 $35 [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.