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
Nevada
Hospital Address Code Price Last Updated
Southern Hills Hospital & Medical Center 9300 W Sunset Rd, Las Vegas Q4114 $14,292 [source] 4 years ago
Mountainview Hospital 3100 N Tenaya Way, Las Vegas Q4114 $15,474 [source] 4 years ago
Valley Hospital Medical Center 620 Shadow Lane, Las Vegas Q4114 $18,169 [source] 4 years ago
Sunrise Hospital & Medical Center 3186 S Maryland Pkwy, Las Vegas Q4114 $22,696 [source] 4 years ago
Spring Valley Medical Center 5400 S Rainbow Blvd, Las Vegas Q4114 $43,497 [source] 4 years ago
Summerlin Hospital Medical Center 657 Town Center Dr, Las Vegas Q4114 $43,497 [source] 4 years ago
Henderson Hospital 1050 West Galleria Drive, Henderson Q4114 $44,300 [source] 4 years ago
Centennial Hills Hospital Medical Center 6900 N Durango Drive, Las Vegas Q4114 $44,300 [source] 4 years ago
Desert Springs Hospital 2075 E Flamingo Rd, Las Vegas Q4114 $44,519 [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.