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
Michigan
Hospital Address Code Price Last Updated
Up Health System – Marquette 580 West College Avenue, Marquette Q4116 $98 [source] 4 years ago
Mclaren Greater Lansing 401 W Greenlawn Ave, Lansing Q4116 $103 [source] 4 years ago
Mclaren Central Michigan 1221 South Dr, Mount Pleasant Q4116 $127 [source] 4 years ago
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q4116 $314 [source] 4 years ago
Oakwood Healthcare, Inc. 5450 Fort St, Trenton Q4116 $342 [source] 4 years ago
Oakwood Healthcare, Inc. 33155 Annapolis St, Wayne Q4116 $342 [source] 4 years ago
William Beaumont Hospital 18181 Oakwood Blvd, Dearborn Q4116 $342 [source] 4 years ago
Oakwood Health Promotions, Inc. 16391 Rotunda Dr, Dearborn Q4116 $342 [source] 4 years ago
Oakwood Healthcare Inc Beaumont Service Center, Q4116 $342 [source] 4 years ago
Oakwood Healthcare, Inc. 18101 Oakwood Blvd, Dearborn Q4116 $342 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren Q4116 $1,806 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4116 $2,074 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4116 $3,141 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4116 $3,524 [source] 4 years ago
Karmanos Cancer Institute 4100 John R St, Detroit Q4116 $3,647 [source] 4 years ago
Midmichigan Medical Center Gladwin , Gladwin Q4116 $6,134 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q4116 $9,643 [source] 4 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer Q4116 $10,299 [source] 4 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q4116 $15,368 [source] 4 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q4116 $15,368 [source] 4 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint Q4116 $21,099 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre, Troy Q4116 $23,561 [source] 4 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy Q4116 $23,561 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q4116 $23,561 [source] 4 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak Q4116 $60,083 [source] 4 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak Q4116 $60,083 [source] 4 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak Q4116 $60,083 [source] 4 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak Q4116 $60,083 [source] 4 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak Q4116 $60,083 [source] 4 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak Q4116 $60,083 [source] 4 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak Q4116 $60,083 [source] 4 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak Q4116 $60,083 [source] 4 years ago
Botsford Continuing Care Corporation 21450 Archwood Cir, Farmington Q4116 $94,718 [source] 4 years ago
Botsford General Hospital 28050 Grand River Ave, Farmington Q4116 $94,718 [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.