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
Tennessee
Hospital Address Code Price Last Updated
Ascension Saint Thomas Stones River 324 Doolittle Rd, Woodbury Q4111 $15 [source] 4 years ago
Ascension Saint Thomas Dekalb 520 W Main St, Smithville Q4111 $15 [source] 4 years ago
Ascension Saint Thomas Highlands 401 Sewell Dr, Sparta Q4111 $15 [source] 4 years ago
Saint Thomas Hickman Hospital 1518 Highway 100, Centerville Q4111 $15 [source] 4 years ago
Southern Tennessee Regional Health System - Winchester 185 Hospital Road, Winchester Q4111 $60 [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.