Code: Q4116

Description:
Description: Alloderm, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
ALLODERM 185 SQCM
ALLODERM 185 SQ CM
ALLODERM 164 SQ CM
ALLODERM 240 SQ CM
ALLODERM 164 SQCM
ALLODERM SLCT 132 SQ CM
ALLODERM 327 SQ CM
ALLODERM SLCTRST 400SQCM
ALLODRM RST LPRF 327SQCM
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: Q4115
GRAFT SOFT TISSUE FROZEN CADAVER
Code: Q4117
HYALOMATRIX 100SQCM
Code: Q4118
MATRISTEM MICRO 1MG 100
Code: Q4119
Kansas
Hospital Address Code Price Last Updated
Ascension Via Christi Hospital Manhattan, Inc. 1823 College Ave, Manhattan Q4116 $32 [source] 4 years ago
Mt. Carmel Regional Medical Center, Inc. 1 Mt Carmel Way, Pittsburg Q4116 $35 [source] 4 years ago
Adventhealth Ransom Memorial, Inc. 1301 S Main St , Ottawa Q4116 $39 [source] 4 years ago
Menorah Medical Center 5721 W. 119Th Street, Shawnee Mission Q4116 $73 [source] 4 years ago
Saint Luke’s South Hospital 12300 Metcalf Ave, Shawnee Mission Q4116 $742 [source] 4 years ago
Overland Park Regional Medical Center 10500 Quivira Road, Shawnee Mission Q4116 $2,084 [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.