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
Nevada
Hospital Address Code Price Last Updated
Mountainview Hospital 3100 N Tenaya Way, Las Vegas Q4104 $1,806 [source] 4 years ago
Sunrise Hospital & Medical Center 3186 S Maryland Pkwy, Las Vegas Q4104 $1,846 [source] 4 years ago
Southern Hills Hospital & Medical Center 9300 W Sunset Rd, Las Vegas Q4104 $1,852 [source] 4 years ago
Valley Hospital Medical Center 620 Shadow Lane, Las Vegas Q4104 $8,625 [source] 4 years ago
Northern Nevada Medical Center 2375 E Prater Way, Sparks Q4104 $13,736 [source] 4 years ago
Spring Valley Medical Center 5400 S Rainbow Blvd, Las Vegas Q4104 $19,578 [source] 4 years ago
Henderson Hospital 1050 West Galleria Drive, Henderson Q4104 $19,940 [source] 4 years ago
Centennial Hills Hospital Medical Center 6900 N Durango Drive, Las Vegas Q4104 $19,940 [source] 4 years ago
Summerlin Hospital Medical Center 657 Town Center Dr, Las Vegas Q4104 $21,489 [source] 4 years ago
Desert Springs Hospital 2075 E Flamingo Rd, Las Vegas Q4104 $23,922 [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.