Code: Q4108

Description:
Description: Integra matrix, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
INTEGRA MATRIX 125 SQCM
INTEGRA MATRIX 1SQCM
INTEGRA MATRIX 250 SQCM
DRESSING MATRIX 2X2IN
INTEGRA MATRIX WOUND DRESSING, PER SQ CM, 10 X 12.5CM 1 PACK DOMESTIC
INTEGRA MATRIX WOUND DRESSING, PER SQ CM, 10 X 25CM 1 PACK DOMESTIC
INTEGRA MATRIX WOUND DRESSING, PER SQ CM, 20 X 25CM 1 PACK DOMESTIC
INTEGRA MATRIX WOUND DRESSING, PER SQ CM, 5 X 5CM 1 PACK DOMESTIC
INTEGRA WOUND MATRIX (THIN), PER SQ CM, 10 X 12.5CM 1 PACK DOMESTIC
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: Q4107
GRAFTJACKET 8 SQCM
Code: Q4109
SKIN SUBSTITUTE TISSUEMEND PER SQ CM
State Average # Hospitals In Database
Hawaii (HI) $41 5
Oklahoma (OK) $47 1
Illinois (IL) $50 7
New Hampshire (NH) $51 1
Minnesota (MN) $55 14
New Mexico (NM) $65 1
Alabama (AL) $105 1
Kentucky (KY) $129 2
Tennessee (TN) $131 7
Idaho (ID) $246 2
Missouri (MO) $423 3
Georgia (GA) $604 1
Indiana (IN) $946 14
Wisconsin (WI) $1,471 13
Kansas (KS) $1,522 5
New Jersey (NJ) $1,941 2
Michigan (MI) $2,264 10
California (CA) $2,343 31
District of Columbia (DC) $2,445 1
South Carolina (SC) $2,554 1
West Virginia (WV) $3,138 2
Connecticut (CT) $3,611 1
Virginia (VA) $4,333 3
Nevada (NV) $6,141 13
Louisiana (LA) $6,808 3
Maryland (MD) $8,050 5
Colorado (CO) $8,085 2
Massachusetts (MA) $9,760 14
New York (NY) $10,191 3
Florida (FL) $11,969 93
North Carolina (NC) $15,864 18
Texas (TX) $25,004 12

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.