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
Missouri
Hospital Address Code Price Last Updated
Saint Luke’s East Hospital 100 Ne Saint Luke's Blvd, Lees Summit Q4114 $1,601 [source] 4 years ago
Saint Luke’s Hospital 4401 Wornall Rd, Kansas City Q4114 $1,601 [source] 4 years ago
Saint Luke’s North Hospital 5830 Nw Barry Rd, Kansas City Q4114 $3,225 [source] 4 years ago
Centerpoint Medical Center 19600 East 39Th Street, Independence Q4114 $3,327 [source] 4 years ago
Lee's Summit Medical Center 2100 Se Blue Parkway, Lees Summit Q4114 $9,980 [source] 4 years ago
Belton Regional Medical Center 17065 S. 71 Highway, Belton Q4114 $10,479 [source] 4 years ago
Research Medical Center 2316 E Meyer Blvd, Kansas City Q4114 $10,790 [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 §180.