Code: Q4104

Description:
Description: Integra bilayer matrix wound dressing (bmwd), per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
INTEGRA BMWD 500 SQ CM
DRESSING BOVINE COLLAGEN GLYCOSAMINOGLYCAN POLYSILOXANE 5X4IN BIOLOGICAL
DRESSING BOVINE COLLAGEN GLYCOSAMINOGLYCAN POLYSILOXANE 2X2IN BIOLOGICAL
DRESSING BOVINE COLLAGEN GLYCOSAMINOGLYCAN POLYSILOXANE MESH 2X2IN WOUND
Dressing,wound,bilayer,bmw4101
DRESSING BOVINE COLLAGEN GLYCOSAMINOGLYCAN POLYSILOXANE 10X4IN BIOLOGICAL
DRESSING BOVINE COLLAGEN GLYCOSAMINOGLYCAN POLYSILOXANE 10X8IN BIOLOGICAL
INTEGRA 2LAYR MTRX SQ C
INTEGRA BILAYER MATRIX WOUND DRESSING, PER SQ CM, 10 X 12.5CM 1 PACK
Related codes:
Code: Q4100
SKIN SUBSTITUTE NOS
Code: Q4101
APLIGRAF 44 SQ CM
Code: Q4102
OASIS WND MATRX 21 SQCM
Code: Q4103
OASIS BURN MATRIX 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
Illinois (IL) $31 7
Minnesota (MN) $37 14
Hawaii (HI) $39 4
Mississippi (MS) $63 1
Alabama (AL) $100 1
Maine (ME) $143 1
North Dakota (ND) $241 2
Kentucky (KY) $319 2
Michigan (MI) $429 106
Tennessee (TN) $490 7
New Hampshire (NH) $558 5
Indiana (IN) $785 17
Wisconsin (WI) $1,006 18
Pennsylvania (PA) $1,687 1
Georgia (GA) $2,195 5
New Jersey (NJ) $3,187 2
Arizona (AZ) $3,409 1
Massachusetts (MA) $3,713 14
Connecticut (CT) $3,741 4
Idaho (ID) $4,071 3
New Mexico (NM) $4,260 1
Oklahoma (OK) $4,296 2
Missouri (MO) $4,312 7
Virginia (VA) $4,670 3
District of Columbia (DC) $5,398 2
Iowa (IA) $6,510 3
Nebraska (NE) $6,510 11
Kansas (KS) $6,557 7
Maryland (MD) $7,037 8
California (CA) $7,657 40
Colorado (CO) $10,010 2
Nevada (NV) $10,634 13
West Virginia (WV) $11,258 3
New York (NY) $11,792 3
Louisiana (LA) $15,919 3
Florida (FL) $16,481 94
Texas (TX) $17,494 55
Ohio (OH) $17,849 10
North Carolina (NC) $28,774 24
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.