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
Nebraska
Hospital Address Code Price Last Updated
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln Q4114 $3,752 [source] 4 years ago
Chi Health Good Samaritan 10 E 31St St, Kearney Q4114 $3,752 [source] 4 years ago
Chi Health Lakeside 17201 Wright St, Omaha Q4114 $3,752 [source] 4 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler Q4114 $3,752 [source] 4 years ago
Chi Health Midlands 11111 S 84Th St, Papillion Q4114 $3,752 [source] 4 years ago
Chi Health Plainview 704 N 3Rd St, Plainview Q4114 $3,752 [source] 4 years ago
Chi Health St. Mary 1301 Grundman Blvd, Nebraska City Q4114 $3,752 [source] 4 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha Q4114 $3,752 [source] 4 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha Q4114 $3,752 [source] 4 years ago
Chi Health St. Francis 2116 W Faidley Ave, Grand Island Q4114 $3,752 [source] 4 years ago
Chi Health Nebraska Heart 7500 So. 91St St., Lincoln Q4114 $3,752 [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.