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
Nevada
Hospital Address Code Price Last Updated
Southern Hills Hospital & Medical Center 9300 W Sunset Rd, Las Vegas Q4108 $1,700 [source] 4 years ago
Sunrise Hospital & Medical Center 3186 S Maryland Pkwy, Las Vegas Q4108 $1,828 [source] 4 years ago
Mountainview Hospital 3100 N Tenaya Way, Las Vegas Q4108 $1,921 [source] 4 years ago
Spring Valley Medical Center 5400 S Rainbow Blvd, Las Vegas Q4108 $8,944 [source] 4 years ago
Centennial Hills Hospital Medical Center 6900 N Durango Drive, Las Vegas Q4108 $8,944 [source] 4 years ago
Summerlin Hospital Medical Center 657 Town Center Dr, Las Vegas Q4108 $8,944 [source] 4 years ago
Desert Springs Hospital 2075 E Flamingo Rd, Las Vegas Q4108 $8,989 [source] 4 years ago
Valley Hospital Medical Center 620 Shadow Lane, Las Vegas Q4108 $9,033 [source] 4 years ago
Desert View Regional Medical Center 360 S Lola Ln, Pahrump Q4108 $10,407 [source] 4 years ago
Henderson Hospital 1050 West Galleria Drive, Henderson Q4108 $13,670 [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.