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
Wisconsin
Hospital Address Code Price Last Updated
River Falls Area Hospital , River Falls Q4116 $13 [source] 4 years ago
Howard Young Medical Center Inc Of Woodruff Wisconsin 240 Maple Street, Woodruff Q4116 $38 [source] 4 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand Q4116 $39 [source] 4 years ago
Aurora Medical Center Burlington 252 Mchenry St, Burlington Q4116 $42 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q4116 $42 [source] 4 years ago
Ascension Calumet Hospital 614 Memorial Dr, Chilton Q4116 $44 [source] 4 years ago
Aurora Sheboygan Memorial Medical Center 2629 N 7Th St, Sheboygan Q4116 $47 [source] 4 years ago
Aurora Medical Center Of Oshkosh 855 N Westhaven Dr, Oshkosh Q4116 $60 [source] 4 years ago
Aurora Medical Center Kenosha 10400 75Th St, Kenosha Q4116 $70 [source] 4 years ago
Aurora Baycare 1160 Kepler Dr, Green Bay Q4116 $75 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee Q4116 $89 [source] 4 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee Q4116 $95 [source] 4 years ago
Aurora Medical Center Of Washington County 1032 E Sumner St, Hartford Q4116 $98 [source] 4 years ago
Aurora Medical Center Grafton 975 Port Washington Road, Grafton Q4116 $108 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee Q4116 $148 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q4116 $154 [source] 4 years ago
Aurora Medical Center Bay Area 3003 University Dr, Marinette Q4116 $1,203 [source] 4 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, Q4116 $3,930 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau Q4116 $3,930 [source] 4 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown Q4116 $9,694 [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.