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
Michigan
Hospital Address Code Price Last Updated
Up Health System – Marquette 580 West College Avenue, Marquette Q4103 $13 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren Q4103 $3,694 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4103 $4,241 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4103 $6,424 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4103 $7,207 [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.