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

Missouri

Hospital	Address	Code	Price	Last Updated
Centerpoint Medical Center	19600 East 39Th Street, Independence	Q4104	$102 [source]	4 years ago
Saint Luke’s Hospital	4401 Wornall Rd, Kansas City	Q4104	$104 [source]	4 years ago
Research Medical Center	2316 E Meyer Blvd, Kansas City	Q4104	$201 [source]	4 years ago
Lee's Summit Medical Center	2100 Se Blue Parkway, Lees Summit	Q4104	$9,175 [source]	4 years ago
Belton Regional Medical Center	17065 S. 71 Highway, Belton	Q4104	$11,223 [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.