Code: Q4122

Description:
Description: Dermacell, dermacell awm or dermacell awm porous, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
DERMACELL AWM MSH 4SQCM
DERMACELL 180 SQCM
DERMACELL 6X12CM 1.25-2MM
GRAFT MESHED 3X3CM/9SQ CM (DCELL111)
GRAFT MESHED 4X4CMX0.8MM/16SQ CM (DCELL1
TISSUE DERMACELL 8X16CM .75-1.50MM
TISSUE DERMACELL 16X20CM 0.6-1.05MM MICROPERF
TISSUE DERMACELL 10X18 0.6-1.05MM MICROPERF
TISSUE DERMACELL 12X21 0.6-1.05MM MICROPERF
Related codes:
Code: Q4120
Code: Q4121
THERASKIN 6SQCM
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
California
Hospital Address Code Price Last Updated
Los Robles Regional Medical Center 215 West Janss Rd, Thousand Oaks Q4122 $438 [source] 4 years ago
California Pacific Medical Center - Davies Campus 45 Castro St, San Francisco Q4122 $6,935 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond Q4122 $8,801 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco Q4122 $8,801 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills Q4122 $8,801 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento Q4122 $8,801 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch Q4122 $8,801 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto Q4122 $8,801 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville Q4122 $8,801 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro Q4122 $8,801 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek Q4122 $8,801 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara Q4122 $8,801 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento Q4122 $8,801 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon Q4122 $8,801 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City Q4122 $8,801 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo Q4122 $8,801 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael Q4122 $8,801 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco Q4122 $8,801 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno Q4122 $8,801 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville Q4122 $8,801 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose Q4122 $8,801 [source] 4 years ago
Sutter Solano Medical Center 300 Hospital Dr, Vallejo Q4122 $11,110 [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.