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
Indiana
Hospital Address Code Price Last Updated
Ascension St. Vincent Warrick 1116 Millis Ave, Boonville Q4114 $101 [source] 4 years ago
Ascension St. Vincent Hospital 2001 W 86Th St, Indianapolis Q4114 $101 [source] 4 years ago
Ascension Medical Group St. Vincent 301 Henry St, North Vernon Q4114 $101 [source] 4 years ago
Ascension St. Vincent Evansville 3700 Washington Ave, Evansville Q4114 $101 [source] 4 years ago
Ascension St. Vincent Williamsport 412 N Monroe St, Williamsport Q4114 $101 [source] 4 years ago
St Vincent Salem Hospital Inc 911 N Shelby St, Salem Q4114 $101 [source] 4 years ago
St. Vincent Mercy Hospital 1331 S A St, Elwood Q4114 $101 [source] 4 years ago
Ascension St. Vincent Dunn 1600 23Rd St, Bedford Q4114 $101 [source] 4 years ago
Ascension St. Vincent Randolph 473 E Greenville Ave, Winchester Q4114 $101 [source] 4 years ago
Ascension St. Vincent Carmel 13500 N Meridian St, Carmel Q4114 $101 [source] 4 years ago
Ascension St. Vincent Anderson 2015 Jackson St, Anderson Q4114 $101 [source] 4 years ago
Ascension St. Vincent Heart Center 10580 N Meridian St, Indianapolis Q4114 $101 [source] 4 years ago
St. Vincent Clay Hospital, Inc 1206 E National Ave, Brazil Q4114 $6,012 [source] 4 years ago
Ascension St Vincent Fishers 13861 Olio Road, Q4114 $6,012 [source] 4 years ago
Franciscan Health Crown Point , Crown Point Q4114 $12,950 [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.