Code: Q4103

Description:
Description: Oasis burn matrix, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
OASIS BURN MATRIX PER SQ CM
OASIS BURN MATRIX 3x7PERSQCM
OASIS BURN MATRIX 7x20PERSQCM
OASIS BURN MATRIX 7x10PERSQCM
Related codes:
Code: Q4100
SKIN SUBSTITUTE NOS
Code: Q4101
APLIGRAF 44 SQ CM
Code: Q4102
OASIS WND MATRX 21 SQCM
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
Hawaii (HI) $5 5
Kansas (KS) $8 1
Illinois (IL) $10 7
Wisconsin (WI) $12 3
Oklahoma (OK) $15 1
California (CA) $25 20
Alabama (AL) $28 1
Missouri (MO) $34 1
Tennessee (TN) $36 1
Delaware (DE) $40 1
Connecticut (CT) $41 1
North Carolina (NC) $64 6
West Virginia (WV) $69 1
Texas (TX) $74 3
Kentucky (KY) $302 2
Indiana (IN) $946 14
New York (NY) $1,084 1
Michigan (MI) $4,316 5

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.