Code: Q4110

Description:
Description: Primatrix, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
PRIMATRIX 16 SQCM
PRIMATRIX 36 SQCM
PRIMATRIX 96 SQCM
PRIMATRIX 96SQCM
PRIMATRIX 1SQCM
PRIMATRIX 120 SQCM
GRAFT PRIMATRIX MESHED 10X25 607-005-125
PRIMATRIX AG 2:1 MESHED, PER SQ CM, 6 X 6CM
PRIMATRIX AG MESHED, PER SQ CM, 10 X 25CM
Related codes:
Code: Q4111
GAMMAGRAFT 12 SQCM
Code: Q4112
CYMETRA ALLOGRFT 1 CC
Code: Q4113
GRAFTJACKET XPRESS 1CC
Code: Q4114
INTEGRA WOUND MATRX 1 CC
Code: Q4115
GRAFT SOFT TISSUE FROZEN CADAVER
Code: Q4116
ALLODERM 1SQCM
Code: Q4117
HYALOMATRIX 100SQCM
Code: Q4118
MATRISTEM MICRO 1MG 100
Code: Q4119
Nebraska
Hospital Address Code Price Last Updated
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln Q4110 $6,500 [source] 4 years ago
Chi Health Good Samaritan 10 E 31St St, Kearney Q4110 $6,500 [source] 4 years ago
Chi Health Lakeside 17201 Wright St, Omaha Q4110 $6,500 [source] 4 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler Q4110 $6,500 [source] 4 years ago
Chi Health Midlands 11111 S 84Th St, Papillion Q4110 $6,500 [source] 4 years ago
Chi Health Plainview 704 N 3Rd St, Plainview Q4110 $6,500 [source] 4 years ago
Chi Health St. Mary 1301 Grundman Blvd, Nebraska City Q4110 $6,500 [source] 4 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha Q4110 $6,500 [source] 4 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha Q4110 $6,500 [source] 4 years ago
Chi Health St. Francis 2116 W Faidley Ave, Grand Island Q4110 $6,500 [source] 4 years ago
Chi Health Nebraska Heart 7500 So. 91St St., Lincoln Q4110 $6,500 [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.