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
Maryland
Hospital Address Code Price Last Updated
Atlantic General Hospital Corp 9733 Healthway Dr, Berlin Q4121 $18 [source] 4 years ago
Northwest Hospital Center 5401 Old Court Rd, Randallstown Q4121 $271 [source] 4 years ago
The Union Memorial Hospital 201 E University Pkwy, Baltimore Q4121 $1,965 [source] 4 years ago
Upmc Western Maryland 10701 New Georges Creek Rd Sw, Frostburg Q4121 $2,052 [source] 4 years ago
The Good Samaritan Hospital 5601 Loch Raven Blvd, Baltimore Q4121 $2,665 [source] 4 years ago
Harbor Hospital 3001 S Hanover St, Brooklyn Q4121 $3,151 [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.