Code: Q4107

Description:
Description: Graftjacket, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
GRAFTJACKET 25 SQCM
GRAFTJACKET 1SQCM
GRAFTJACKET 50 SQCM
GRAFTJACKET 16 SQCM
GRAFTJACKET 28 SQCM
GRAFTJACKET NOW 8SQCM
GRAFTJACKET 32 SQCM
GRAFT GRAFTJACKET ACELLULAR DERMAL MATRIX 7CMX4CMX1.5MM SKIN REGENERATIVE
GRAFT GRAFTJACKET ULTRATHICK ACELLULAR DERMAL MATRIX 7X4CM SKIN MAXIMUM
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: Q4106
DERMAGRAFT 37.5 SQCM
Code: Q4108
INTEGRA MATRIX 25 SQCM
Code: Q4109
SKIN SUBSTITUTE TISSUEMEND PER SQ CM
Hawaii
Hospital Address Code Price Last Updated
Hale Ho'ola Hamakua 100 Keokea Pl, Kula Q4107 $93 [source] 4 years ago
Kau Hospital 1 Kamani Street, Pahala Q4107 $93 [source] 4 years ago
Kohala Hospital 54 383 Hospital Road, Kapaau Q4107 $93 [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.