Code: Q4113

Description:
Description: Graftjacket xpress, injectable, 1 cc
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
Graft Jacket Xpress 1cc
GRFTJCKT XPRSS FLW 2ML PER 1CC
GRAFTJACKET XPRESS INJECTABLE 1 CC
Related codes:
Code: Q4110
PRIMATRIX 64 SQCM
Code: Q4111
GAMMAGRAFT 12 SQCM
Code: Q4112
CYMETRA ALLOGRFT 1 CC
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
Florida
Hospital Address Code Price Last Updated
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4113 $758 [source] 4 years ago
Adventhealth Zephyrhills 7050 Gall Blvd, Zephyrhills Q4113 $2,275 [source] 4 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q4113 $2,275 [source] 4 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q4113 $2,275 [source] 4 years ago
Adventhealth Ocala 1500 Sw 1St Ave, Ocala Q4113 $2,275 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4113 $2,275 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4113 $2,275 [source] 4 years ago
Florida Hospital Carrollwood 7171 N Dale Mabry Hwy, Tampa Q4113 $2,275 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4113 $2,275 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4113 $2,275 [source] 4 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q4113 $2,275 [source] 4 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q4113 $2,275 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4113 $2,275 [source] 4 years ago
Adventhealth Dade City 13100 Fort King Rd, Dade City Q4113 $2,275 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4113 $2,275 [source] 4 years ago
Adventhealth Lake Wales 410 South 11Th Street, Lake Wales Q4113 $2,275 [source] 4 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q4113 $2,275 [source] 4 years ago
Adventhealth New Smyrna Beach 401 Palmetto St, New Smyrna Beach Q4113 $2,275 [source] 4 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q4113 $2,275 [source] 4 years ago
Adventist Health System/Sunbelt, Inc. 4001 W Linebaugh Ave, Tampa Q4113 $2,275 [source] 4 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q4113 $3,076 [source] 4 years ago
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q4113 $3,396 [source] 4 years ago
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q4113 $4,326 [source] 4 years ago
Englewood Community Hospital 700 Medical Blvd, Englewood Q4113 $5,668 [source] 4 years ago
St. Petersburg General Hospital 6500 38Th Ave N, Saint Petersburg Q4113 $5,668 [source] 4 years ago
Largo Medical Center 201 14Th St Sw, Largo Q4113 $5,668 [source] 4 years ago
Capital Regional Medical Center 2626 Capital Medical Blvd, Tallahassee Q4113 $5,703 [source] 4 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q4113 $8,470 [source] 4 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q4113 $8,470 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4113 $9,023 [source] 4 years ago
Adventhealth Daytona Beach 301 Memorial Medical Pkwy, Daytona Beach Q4113 $9,898 [source] 4 years ago
Palms Of Pasadena Hospital 1501 Pasadena Ave, Saint Petersburg Q4113 $10,198 [source] 4 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q4113 $10,266 [source] 4 years ago
Memorial Hospital Of Tampa 2901 W. Swann Avenue, Tampa Q4113 $11,278 [source] 4 years ago
Fawcett Memorial Hospital 21298 Olean Blvd, Port Charlotte Q4113 $12,279 [source] 4 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q4113 $13,572 [source] 4 years ago
Oak Hill Hospital 11375 Cortez Blvd, Brooksville Q4113 $14,065 [source] 4 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q4113 $14,292 [source] 4 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q4113 $15,903 [source] 4 years ago
Medical Center Of Trinity 9330 State Rd 54, New Port Richey Q4113 $16,150 [source] 4 years ago
Brandon Regional Hospital 119 Oakfield Dr, Brandon Q4113 $16,965 [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.