Code: Q4121

Description:
Description: Theraskin, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
THERASKIN 13SQCM
THERASKIN 39SQCM
THERASKIN 18SQCM
THERASKIN 13 SQ CM
THERASKIN LG 2X3IN 102TSL
GRAFT THERASKIN 13 SQ CM (101TSS)
GRAFT THERASKIN 39 SQ CM (102TSL)
GRAFT SKIN 2X1IN THERASKIN CRYOPRESERVE MESH ALLOGRAFT
GRAFT SKIN 3X2IN THERASKIN 1.5:1 LARGE MESH ALLOGRAFT CRYOPRESERVE
Related codes:
Code: Q4120
Code: Q4122
DERMACELLAWMPORO 1SQCM
Code: Q4123
ALLOSKIN RT 1SQCM
Code: Q4124
OASIS TRI MATRIX 35SQCM
Code: Q4125
ARTHROFLX 12SQCM .5M THK
Code: Q4126
DERMASPAN 25 SQ CM
Code: Q4127
Description: Talymed, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q4128
FLEXALLOPMATR HD 1SQCM
Georgia
Hospital Address Code Price Last Updated
Murray Medical Center, Inc. 104 Hospital Dr, Chatsworth Q4121 $122 [source] 4 years ago
Adventist Health System Georgia, Inc 170 Curtis Pkwy Ne, Calhoun Q4121 $122 [source] 4 years ago
Adventhealth Gordon 105 Willowbrook Way Se, Calhoun Q4121 $122 [source] 4 years ago
Murray County Memorial Hospital Authority 707 Old Dalton Ellijay Rd, Chatsworth Q4121 $122 [source] 4 years ago
Adventist Health System Georgia Inc 1035 Red Bud Rd Ne, Calhoun Q4121 $122 [source] 4 years ago
Coliseum Health System 350 Hospital Dr, Macon Q4121 $548 [source] 4 years ago
Memorial Health 4700 Waters Avenue, Savannah Q4121 $1,180 [source] 4 years ago
Cartersville Medical Center 960 Joe Frank Harris Pkwy, Cartersville Q4121 $1,396 [source] 4 years ago
Eastside Medical Center 1700 Medical Way, Snellville Q4121 $3,778 [source] 4 years ago
Wellstar Atlanta Medical Center 303 Parkway Dr Ne, Atlanta, Georgia, Atlanta Q4121 $3,830 [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.