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
Missouri
Hospital Address Code Price Last Updated
Research Medical Center 2316 E Meyer Blvd, Kansas City Q4116 $73 [source] 4 years ago
Centerpoint Medical Center 19600 East 39Th Street, Independence Q4116 $81 [source] 4 years ago
Saint Luke’s East Hospital 100 Ne Saint Luke's Blvd, Lees Summit Q4116 $91 [source] 4 years ago
Saint Luke’s North Hospital 5830 Nw Barry Rd, Kansas City Q4116 $459 [source] 4 years ago
Saint Luke’s Hospital 4401 Wornall Rd, Kansas City Q4116 $731 [source] 4 years ago
Belton Regional Medical Center 17065 S. 71 Highway, Belton Q4116 $8,615 [source] 4 years ago
Lee's Summit Medical Center 2100 Se Blue Parkway, Lees Summit Q4116 $11,365 [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.