Code: Q4118

Description:
Description: Matristem micromatrix, 1 mg
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
MATRISTEM MICRO 1MG 500
MATRISTEM MICROMATRX 1MG
WOUND SHEET MATRI 3X7
MATRISTEM MICRO 1MG 200
MATRISTEM MICRO 1MG 1000
MATRISTEM MICRO 1 MG
MATRISTEM MICRO 1MG 30MG
MATRISTEM MCRMATRX 100MG
GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULAR MATRIX
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: Q4117
HYALOMATRIX 100SQCM
Code: Q4119
State Average # Hospitals In Database
Minnesota (MN) $3 1
Illinois (IL) $3 1
Oklahoma (OK) $5 1
Wyoming (WY) $6 2
Missouri (MO) $6 5
Louisiana (LA) $8 2
Alabama (AL) $9 4
Arizona (AZ) $10 2
Tennessee (TN) $14 5
Kansas (KS) $43 5
Pennsylvania (PA) $57 2
Virginia (VA) $62 2
Kentucky (KY) $84 5
New Mexico (NM) $109 1
Massachusetts (MA) $607 14
Indiana (IN) $799 19
New Jersey (NJ) $933 2
Connecticut (CT) $1,332 2
Wisconsin (WI) $1,743 13
Nevada (NV) $1,768 13
District of Columbia (DC) $1,971 2
Washington (WA) $2,096 4
California (CA) $2,970 41
Maryland (MD) $3,105 8
Georgia (GA) $3,492 13
Idaho (ID) $4,439 6
New York (NY) $4,715 2
Iowa (IA) $4,725 3
Nebraska (NE) $4,725 11
Florida (FL) $5,015 100
West Virginia (WV) $5,027 4
North Carolina (NC) $5,147 24
Ohio (OH) $6,536 10
South Carolina (SC) $7,188 4
Michigan (MI) $8,744 103
Texas (TX) $9,162 60
New Hampshire (NH) $17,401 3

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.