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
Texas
Hospital Address Code Price Last Updated
Ascension Providence 6901 Medical Pkwy, Woodway Q4116 $75 [source] 4 years ago
Adventhealth Central Texas 2201 Clear Creek Rd, Killeen Q4116 $136 [source] 4 years ago
Palestine Regional Medical Center 2900 South Loop 256, Palestine Q4116 $175 [source] 4 years ago
Medical City Lewisville 500 W Main St, Lewisville Q4116 $239 [source] 4 years ago
Texas Health Huguley 11801 South Fwy, Burleson Q4116 $341 [source] 4 years ago
Ennis Regional Medical Center 2201 West Lampasas, Waxahachie Q4116 $797 [source] 4 years ago
South Texas Health System Children’s 1102 W. Trenton Road, Edinburg Q4116 $2,281 [source] 4 years ago
South Texas Health System Mcallen 301 W. Expressway 83, Mcallen Q4116 $2,281 [source] 4 years ago
South Texas Health System Heart 1900 South D Street, Mcallen Q4116 $2,281 [source] 4 years ago
Adventhealth Rollins Brook 608 N Key Ave, Lampasas Q4116 $2,516 [source] 4 years ago
Texas Children's Hospital 6621 Fannin St Houston, Houston Q4116 $2,530 [source] 4 years ago
Fort Duncan Regional Medical Center 3333 N. Foster Maldonado Blvd., Eagle Pass Q4116 $2,617 [source] 4 years ago
Doctors Hospital Of Laredo 10700 Mcpherson Road, Laredo Q4116 $2,645 [source] 4 years ago
Northwest Texas Healthcare System 1501 S. Coulter, Amarillo Q4116 $5,218 [source] 4 years ago
Texoma Medical Center 5016 South Us Highway 75, Denison Q4116 $7,312 [source] 4 years ago
Baylor Scott & White Medical Center - College Station 700 Scott And White Dr, College Station Q4116 $11,350 [source] 4 years ago
Baylor Scott & White Medical Center - Taylor 305 Mallard Ln, Taylor Q4116 $11,350 [source] 4 years ago
Baylor Scott & White Medical Center - Marble Falls 810 W. State Highway 71, Marble Falls Q4116 $11,350 [source] 4 years ago
Baylor Scott & White Medical Center - Brenham 700 Medical Pkwy, Brenham Q4116 $11,350 [source] 4 years ago
Baylor Scott & White The Heart Hospital - Plano 1100 Allied Dr, Plano Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Emergency Hospital - Murphy 511 W Fm 544 Ste 100, Plano Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Continuing Care Hospital - Temple 546 N Kegley Rd, Temple Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Heart And Vascular Hospital - Dallas 621 N Hall St, Dallas Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Plano 4700 Alliance Blvd, Plano Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Emergency Center - Forney 757 E Us Highway 80 Ste 150, Forney Q4116 $14,188 [source] 4 years ago
Baylor Scott & White All Saints Medical Center - Fort Worth 1400 8Th Ave, Fort Worth Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Centennial 12505 Lebanon Rd, Frisco Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Irving 1901 N Macarthur Blvd, Irving Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Emergency Hospital - Aubrey 26791 Us Highway 380 E, Aubrey Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Grapevine 1650 W College St, Grapevine Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Lakeway 100 Medical Pkwy, Austin Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Buda 5330 Overpass Rd, Buda Q4116 $14,188 [source] 4 years ago
Baylor Scott & White The Heart Hospital - Denton 2801 S Mayhill Rd, Denton Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Lake Pointe 6800 Scenic Dr, Rowlett Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Waxahachie 2400 N Interstate 35E, Waxahachie Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Round Rock 300 University Blvd, Sandy Q4116 $14,188 [source] 4 years ago
Baylor Scott & White Medical Center - Pflugerville 2600 E Pflugerville Pkwy Ste 100, Pflugerville Q4116 $14,188 [source] 4 years ago
Hca Houston Healthcare 3737 Buffalo Speedway Suite 140, Houston Q4116 $24,492 [source] 4 years ago
Medical City Arlington 3301 Matlock Rd, Arlington Q4116 $29,030 [source] 4 years ago
Medical City Frisco 5500 Frisco Square Blvd, Frisco Q4116 $33,017 [source] 4 years ago
Woman's Hospital Of Texas 7600 Fannin, Houston Q4116 $60,361 [source] 4 years ago
Rio Grande Regional Hospital 101 East Ridge Road, Mcallen Q4116 $67,767 [source] 4 years ago
Medical City Denton 3535 S Interstate 35, Corinth Q4116 $72,173 [source] 4 years ago
Medical City Las Colinas 6800 N Macarthur Blvd, Irving Q4116 $77,680 [source] 4 years ago
Medical City North Hills 4401 Booth Calloway Rd, North Richland Hills Q4116 $135,555 [source] 4 years ago
Medical City Alliance 3101 N Tarrant Pkwy, Fort Worth Q4116 $136,048 [source] 4 years ago
Medical City Dallas 13155 Noel Rd. Suite 200, Dallas Q4116 $142,602 [source] 4 years ago
Medical City Fort Worth 900 8Th Ave, Fort Worth Q4116 $146,166 [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.