Code: Q4117

Description:
Description: Hyalomatrix, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
HYALOMATRIX 1SQCM
HYALOMATRIX 200SQCM
HYALOMATRIX 25SQCM
DRSNG HYALOMATRIX WND PER SQ CM (18X20CM)
DRESSING HYALOMATRIX 2.5X2.5CM
HYALOMATRIX NON SIL 10X20CM (PER 1 CM)
HYALOMATRIX NON SIL 10X10CM (PER 1 CM)
HYALOMATRIX 10 SQCM
HYALOMATRIX 5.0 SQCM
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: Q4116
ALLODERM 1SQCM
Code: Q4118
MATRISTEM MICRO 1MG 100
Code: Q4119
California
Hospital Address Code Price Last Updated
West Hills Hospital 7300 Medical Center Dr, West Hills Q4117 $154 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond Q4117 $261 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco Q4117 $261 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills Q4117 $261 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento Q4117 $261 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch Q4117 $261 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto Q4117 $261 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville Q4117 $261 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro Q4117 $261 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek Q4117 $261 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara Q4117 $261 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento Q4117 $261 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon Q4117 $261 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City Q4117 $261 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo Q4117 $261 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael Q4117 $261 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco Q4117 $261 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno Q4117 $261 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville Q4117 $261 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose Q4117 $261 [source] 4 years ago
Los Robles Regional Medical Center 215 West Janss Rd, Thousand Oaks Q4117 $323 [source] 4 years ago
Corona Regional Medical Center 800 S. Main Street, Corona Q4117 $386 [source] 4 years ago
Palmdale Regional Medical Center 38600 Medical Center Drive, Palmdale Q4117 $1,050 [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.