Code: Q4114

Description:
Description: Integra flowable wound matrix, injectable, 1 cc
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
INTEGRA FLW WM 1CC
SEALR WOUND MATRIX FLO 3 ML FWD301
INTEGRA FLOWABLE WOUND MATRIX, PER 1ML, 3 ML
INTEGRA FLOWABLE WOUND MATRIX INJECTABLE 1 CC
Related codes:
Code: Q4110
PRIMATRIX 64 SQCM
Code: Q4111
GAMMAGRAFT 12 SQCM
Code: Q4112
CYMETRA ALLOGRFT 1 CC
Code: Q4113
GRAFTJACKET XPRESS 1CC
Code: Q4115
GRAFT SOFT TISSUE FROZEN CADAVER
Code: Q4116
ALLODERM 1SQCM
Code: Q4117
HYALOMATRIX 100SQCM
Code: Q4118
MATRISTEM MICRO 1MG 100
Code: Q4119
Georgia
Hospital Address Code Price Last Updated
Murray Medical Center, Inc. 104 Hospital Dr, Chatsworth Q4114 $4,733 [source] 4 years ago
Adventist Health System Georgia, Inc 170 Curtis Pkwy Ne, Calhoun Q4114 $4,733 [source] 4 years ago
Adventhealth Gordon 105 Willowbrook Way Se, Calhoun Q4114 $4,733 [source] 4 years ago
Murray County Memorial Hospital Authority 707 Old Dalton Ellijay Rd, Chatsworth Q4114 $4,733 [source] 4 years ago
Adventist Health System Georgia Inc 1035 Red Bud Rd Ne, Calhoun Q4114 $4,733 [source] 4 years ago
Memorial Health 4700 Waters Avenue, Savannah Q4114 $12,853 [source] 4 years ago
Eastside Medical Center 1700 Medical Way, Snellville Q4114 $35,893 [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.