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
Wisconsin
Hospital Address Code Price Last Updated
Ascension Calumet Hospital 614 Memorial Dr, Chilton Q4118 $5 [source] 4 years ago
Aurora Medical Center Summit 36500 Aurora Dr, Oconomowoc Q4118 $6 [source] 4 years ago
Orthopaedic Hospital Of Wisconsin 475 W River Woods Pkwy, Milwaukee Q4118 $10 [source] 4 years ago
Aurora West Allis Medical Center 8901 W Lincoln Ave, Milwaukee Q4118 $11 [source] 4 years ago
Aurora St Luke's South Shore 5900 S Lake Dr, Cudahy Q4118 $12 [source] 4 years ago
Aurora St. Luke's Medical Center 2900 W Oklahoma Ave, Milwaukee Q4118 $12 [source] 4 years ago
Aurora Sinai Medical Center 945 N 12Th St, Milwaukee Q4118 $15 [source] 4 years ago
Chippewa Valley Hospital & Oakview Care Center, Inc. 1220 3Rd Ave W, Durand Q4118 $162 [source] 4 years ago
Aspirus Stevens Point Hospital 5409 Vern Holmes Dr, Q4118 $5,341 [source] 4 years ago
Aspirus Wausau Hospital 333 Pine Ridge Blvd, Wausau Q4118 $5,341 [source] 4 years ago
Watertown Regional Medical Center 125 Hospital Drive, Watertown Q4118 $5,460 [source] 4 years ago
Prairie Ridge Health 1515 Park Ave, Columbus Q4118 $6,127 [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.