Code: Q4115

Description:
Description: Alloskin, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
Graft St Tis Frzn Cadvr 5100-001
SKIN CRYOPRESERVED MESHED
SKIN CADAVERIC CRYO MESHED
SKIN CRYOPRESERVED 1/2 SQ. FT.
SKIN CRYOPRESERVED MESH 1 SQ CM
Related codes:
Code: Q4110
PRIMATRIX 64 SQCM
Code: Q4111
GAMMAGRAFT 12 SQCM
Code: Q4112
CYMETRA ALLOGRFT 1 CC
Code: Q4113
GRAFTJACKET XPRESS 1CC
Code: Q4114
INTEGRA WOUND MATRX 1 CC
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 Q4115 $20 [source] 4 years ago
Adventist Health System Georgia, Inc 170 Curtis Pkwy Ne, Calhoun Q4115 $20 [source] 4 years ago
Adventhealth Gordon 105 Willowbrook Way Se, Calhoun Q4115 $20 [source] 4 years ago
Murray County Memorial Hospital Authority 707 Old Dalton Ellijay Rd, Chatsworth Q4115 $20 [source] 4 years ago
Adventist Health System Georgia Inc 1035 Red Bud Rd Ne, Calhoun Q4115 $20 [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.