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
Florida
Hospital Address Code Price Last Updated
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q4117 $52 [source] 4 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q4117 $55 [source] 4 years ago
University Hospital & Medical Center 7201 North University Dr, Fort Lauderdale Q4117 $167 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4117 $812 [source] 4 years ago
Florida Hospital Carrollwood 7171 N Dale Mabry Hwy, Tampa Q4117 $812 [source] 4 years ago
Adventist Health System/Sunbelt, Inc. 4001 W Linebaugh Ave, Tampa Q4117 $812 [source] 4 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q4117 $1,543 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4117 $10,152 [source] 4 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q4117 $16,744 [source] 4 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q4117 $24,659 [source] 4 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4117 $31,355 [source] 4 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q4117 $42,832 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4117 $57,009 [source] 4 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q4117 $57,009 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4117 $57,009 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4117 $57,009 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4117 $57,009 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4117 $57,009 [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.