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
Nebraska
Hospital Address Code Price Last Updated
Chi Health St. Elizabeth 555 S. 70Th St., Lincoln Q4116 $11,871 [source] 4 years ago
Chi Health Good Samaritan 10 E 31St St, Kearney Q4116 $11,871 [source] 4 years ago
Chi Health Lakeside 17201 Wright St, Omaha Q4116 $11,871 [source] 4 years ago
Chi Health Schuyler 1721 Colfax St, Schuyler Q4116 $11,871 [source] 4 years ago
Chi Health Midlands 11111 S 84Th St, Papillion Q4116 $11,871 [source] 4 years ago
Chi Health Plainview 704 N 3Rd St, Plainview Q4116 $11,871 [source] 4 years ago
Chi Health St. Mary 1301 Grundman Blvd, Nebraska City Q4116 $11,871 [source] 4 years ago
Chi Health Creighton University Medical Center - Bergan Mercy 7500 Mercy Rd, Omaha Q4116 $11,871 [source] 4 years ago
Chi Health Immanuel 7101 Newport Ave, Omaha Q4116 $11,871 [source] 4 years ago
Chi Health St. Francis 2116 W Faidley Ave, Grand Island Q4116 $11,871 [source] 4 years ago
Chi Health Nebraska Heart 7500 So. 91St St., Lincoln Q4116 $11,871 [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.