Code: Q4111

Description:
Description: Gammagraft, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
GAMMAGRAFT 1SQCM
GAMMAGRAFT 62.50 SQCM
GAMMAGRAFT SKIN SUB
Related codes:
Code: Q4110
PRIMATRIX 64 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
Illinois
Hospital Address Code Price Last Updated
Adventist Bolingbrook Hospital 500 Remington Blvd, Bolingbrook Q4111 $12 [source] 4 years ago
Presence St. Mary's Hospital 500 W Court St, Kankakee Q4111 $16 [source] 4 years ago
Alexian Brothers Medical Center 935 Beisner Rd, Elk Grove Village Q4111 $20 [source] 4 years ago
Adventist Hinsdale Hospital 120 N Oak St, Hinsdale Q4111 $21 [source] 4 years ago
Adventist Lagrange Memorial Hospital 5101 Willow Springs Rd, La Grange Q4111 $21 [source] 4 years ago
Adventist Glenoaks Hospital 701 Winthrop Ave, Glendale Heights Q4111 $21 [source] 4 years ago
St. Alexius Medical Center 1555 Barrington Road, Q4111 $21 [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.