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
Wisconsin
Hospital Address Code Price Last Updated
Howard Young Medical Center Inc Of Woodruff Wisconsin 240 Maple Street, Woodruff Q4113 $408 [source] 4 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton Q4113 $1,062 [source] 4 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand Q4113 $2,275 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q4113 $2,540 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q4113 $2,540 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford Q4113 $2,540 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q4113 $2,540 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette Q4113 $2,540 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q4113 $2,540 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay Q4113 $2,540 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington Q4113 $2,540 [source] 4 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee Q4113 $2,805 [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.