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
Ohio
Hospital Address Code Price Last Updated
Euclid Hospital 18901 Lakeshore Blvd., Cleveland Q4116 $17,990 [source] 4 years ago
Cleveland Clinic Main Campus 9500 Euclid Ave, Cleveland Q4116 $18,400 [source] 4 years ago
South Pointe Hospital 20000 Harvard Rd., Cleveland Q4116 $18,400 [source] 4 years ago
Marymount Hospital 12300 Mccracken Road, Cleveland Q4116 $18,402 [source] 4 years ago
Hillcrest Hospital 6780 Mayfield Rd., Cleveland Q4116 $18,797 [source] 4 years ago
Medina Hospital 1000 E. Washington St., Medina Q4116 $23,495 [source] 4 years ago
Lutheran Hospital 1730 West 25Th Street, Cleveland Q4116 $27,600 [source] 4 years ago
Fairview Hospital 18101 Lorain Ave., Cleveland Q4116 $28,194 [source] 4 years ago
Akron General Lodi Hospital 225 Elyria St., Lodi Q4116 $47,584 [source] 4 years ago
Akron General 1 Akron General Ave., Akron Q4116 $47,584 [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.