Code: Q4106

Description:
Description: Dermagraft, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
DERMAGRAFT 6 SQCM
Dermagraft Per 1 Sq Cm
Dermagraft Skin Sub Per Sq Cm
DERMAGRAFT PER SQ CM
DERMAGRAFT 5X7.5CM PER SQ
DERMAGRAFT 5X7.5 PER SQCM
TY TIB NP MOD PFC SIG 2 86-6022
DERMAGRFT NI-DERM-COM
TISS LIVE DERMAGRFT 5X7.5CM
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: Q4104
INTEGRA BMWD 1SQCM
Code: Q4105
INTEGRA DRTOMNIGF 1SQCM
Code: Q4107
GRAFTJACKET 8 SQCM
Code: Q4108
INTEGRA MATRIX 25 SQCM
Code: Q4109
SKIN SUBSTITUTE TISSUEMEND PER SQ CM
Georgia
Hospital Address Code Price Last Updated
Murray Medical Center, Inc. 104 Hospital Dr, Chatsworth Q4106 $98 [source] 4 years ago
Adventist Health System Georgia, Inc 170 Curtis Pkwy Ne, Calhoun Q4106 $98 [source] 4 years ago
Adventhealth Gordon 105 Willowbrook Way Se, Calhoun Q4106 $98 [source] 4 years ago
Murray County Memorial Hospital Authority 707 Old Dalton Ellijay Rd, Chatsworth Q4106 $98 [source] 4 years ago
Adventist Health System Georgia Inc 1035 Red Bud Rd Ne, Calhoun Q4106 $98 [source] 4 years ago
Wellstar Atlanta Medical Center 303 Parkway Dr Ne, Atlanta, Georgia, Atlanta Q4106 $104 [source] 4 years ago
Redmond Regional Medical Center 501 Redmond Rd, Rome Q4106 $362 [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.