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
Illinois
Hospital Address Code Price Last Updated
Adventist Bolingbrook Hospital 500 Remington Blvd, Bolingbrook Q4103 $7 [source] 4 years ago
Presence St. Mary's Hospital 500 W Court St, Kankakee Q4103 $9 [source] 4 years ago
Alexian Brothers Medical Center 935 Beisner Rd, Elk Grove Village Q4103 $11 [source] 4 years ago
Adventist Hinsdale Hospital 120 N Oak St, Hinsdale Q4103 $12 [source] 4 years ago
Adventist Lagrange Memorial Hospital 5101 Willow Springs Rd, La Grange Q4103 $12 [source] 4 years ago
Adventist Glenoaks Hospital 701 Winthrop Ave, Glendale Heights Q4103 $12 [source] 4 years ago
St. Alexius Medical Center 1555 Barrington Road, Q4103 $12 [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.