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
Wisconsin
Hospital Address Code Price Last Updated
Ascension Calumet Hospital 614 Memorial Dr, Chilton Q4117 $28 [source] 4 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand Q4117 $39 [source] 4 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee Q4117 $60 [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.