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
Texas
Hospital Address Code Price Last Updated
Ascension Providence 6901 Medical Pkwy, Woodway Q4117 $27 [source] 4 years ago
Texas Health Huguley 11801 South Fwy, Burleson Q4117 $39 [source] 4 years ago
Adventhealth Central Texas 2201 Clear Creek Rd, Killeen Q4117 $39 [source] 4 years ago
Adventhealth Rollins Brook 608 N Key Ave, Lampasas Q4117 $39 [source] 4 years ago
South Texas Health System Children’s 1102 W. Trenton Road, Edinburg Q4117 $50 [source] 4 years ago
South Texas Health System Heart 1900 South D Street, Mcallen Q4117 $50 [source] 4 years ago
South Texas Health System Mcallen 301 W. Expressway 83, Mcallen Q4117 $50 [source] 4 years ago
Doctors Hospital Of Laredo 10700 Mcpherson Road, Laredo Q4117 $58 [source] 4 years ago
Fort Duncan Regional Medical Center 3333 N. Foster Maldonado Blvd., Eagle Pass Q4117 $58 [source] 4 years ago
Hca Houston Healthcare 3737 Buffalo Speedway Suite 140, Houston Q4117 $1,892 [source] 4 years ago
Valley Regional Medical Center 100-A Alton Gloor Blvd, Brownsville Q4117 $11,180 [source] 4 years ago
Corpus Christi Medical Center 7101 South Padre Island Dr, Corpus Christi Q4117 $11,482 [source] 4 years ago
Medical City Denton 3535 S Interstate 35, Corinth Q4117 $28,545 [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.