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
Florida
Hospital Address Code Price Last Updated
Adventhealth Ocala 1500 Sw 1St Ave, Ocala Q4108 $95 [source] 4 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q4108 $96 [source] 4 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q4108 $96 [source] 4 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q4108 $96 [source] 4 years ago
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q4108 $96 [source] 4 years ago
Florida Hospital Carrollwood 7171 N Dale Mabry Hwy, Tampa Q4108 $96 [source] 4 years ago
Adventhealth Zephyrhills 7050 Gall Blvd, Zephyrhills Q4108 $96 [source] 4 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q4108 $96 [source] 4 years ago
Adventhealth Dade City 13100 Fort King Rd, Dade City Q4108 $96 [source] 4 years ago
Adventist Health System/Sunbelt, Inc. 4001 W Linebaugh Ave, Tampa Q4108 $96 [source] 4 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q4108 $96 [source] 4 years ago
Adventhealth New Smyrna Beach 401 Palmetto St, New Smyrna Beach Q4108 $96 [source] 4 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q4108 $96 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4108 $96 [source] 4 years ago
West Florida Hospital 8383 N Davis Hwy, Pensacola Q4108 $119 [source] 4 years ago
Memorial Hospital 3625 University Blvd. S, Jacksonville Q4108 $315 [source] 4 years ago
Orange Park Medical Center 2001 Kingsley Avenue, Orange Park Q4108 $401 [source] 4 years ago
Ocala Health 1431 Sw 1St Ave, Ocala Q4108 $546 [source] 4 years ago
Adventhealth Lake Wales 410 South 11Th Street, Lake Wales Q4108 $827 [source] 4 years ago
North Florida Regional Medical Center 6500 W Newberry Rd, Gainesville Q4108 $3,500 [source] 4 years ago
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q4108 $4,542 [source] 4 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q4108 $5,307 [source] 4 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q4108 $5,307 [source] 4 years ago
Englewood Community Hospital 700 Medical Blvd, Englewood Q4108 $5,307 [source] 4 years ago
Poinciana Medical Center 325 Cypress Pkwy, Kissimmee Q4108 $5,307 [source] 4 years ago
Fawcett Memorial Hospital 21298 Olean Blvd, Port Charlotte Q4108 $5,307 [source] 4 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q4108 $6,324 [source] 4 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q4108 $6,324 [source] 4 years ago
Memorial Hospital Of Tampa 2901 W. Swann Avenue, Tampa Q4108 $8,515 [source] 4 years ago
Citrus Memorial Hospital 502 W. Highland Blvd, Inverness Q4108 $9,391 [source] 4 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4108 $11,791 [source] 4 years ago
Largo Medical Center 201 14Th St Sw, Largo Q4108 $14,961 [source] 4 years ago
Osceola Regional Medical Center 700 West Oak St, Kissimmee Q4108 $15,661 [source] 4 years ago
Medical Center Of Trinity 9330 State Rd 54, New Port Richey Q4108 $17,081 [source] 4 years ago
St. Petersburg General Hospital 6500 38Th Ave N, Saint Petersburg Q4108 $17,081 [source] 4 years ago
Brandon Regional Hospital 119 Oakfield Dr, Brandon Q4108 $17,081 [source] 4 years ago
Oak Hill Hospital 11375 Cortez Blvd, Brooksville Q4108 $17,081 [source] 4 years ago
Palms West Hospital 13001 Southern Blvd, Loxahatchee Q4108 $17,340 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4108 $21,438 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4108 $21,438 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4108 $21,438 [source] 4 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q4108 $21,438 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4108 $21,438 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4108 $21,438 [source] 4 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q4108 $21,732 [source] 4 years ago
Jfk Medical Center 5301 S Congress Ave, Lake Worth Q4108 $25,004 [source] 4 years ago
Lawnwood Medical Center & Heart Institute 1700 S 23Rd St, Fort Pierce Q4108 $25,387 [source] 4 years ago
Plantation General Hospital 401 Nw 42 Ave, Fort Lauderdale Q4108 $25,387 [source] 4 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q4108 $28,050 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4108 $28,050 [source] 4 years ago
University Hospital & Medical Center 7201 North University Dr, Fort Lauderdale Q4108 $31,539 [source] 4 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q4108 $31,539 [source] 4 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q4108 $40,128 [source] 4 years ago
Northwest Medical Center 2801 North State Rd 7, Pompano Beach Q4108 $41,062 [source] 4 years ago
Kendall Regional Medical Center 11750 Sw 40 St, Miami Q4108 $47,488 [source] 4 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q4108 $47,488 [source] 4 years ago
Jfk Medical Center - North Campus 2201 45Th St, West Palm Beach Q4108 $47,488 [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.