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
Indiana
Hospital Address Code Price Last Updated
Franciscan Health Michigan City , Michigan City Q4122 $98 [source] 4 years ago
Ascension St. Vincent Warrick 1116 Millis Ave, Boonville Q4122 $101 [source] 4 years ago
Ascension St. Vincent Hospital 2001 W 86Th St, Indianapolis Q4122 $101 [source] 4 years ago
Ascension Medical Group St. Vincent 301 Henry St, North Vernon Q4122 $101 [source] 4 years ago
Ascension St. Vincent Evansville 3700 Washington Ave, Evansville Q4122 $101 [source] 4 years ago
Ascension St. Vincent Williamsport 412 N Monroe St, Williamsport Q4122 $101 [source] 4 years ago
St Vincent Salem Hospital Inc 911 N Shelby St, Salem Q4122 $101 [source] 4 years ago
St. Vincent Mercy Hospital 1331 S A St, Elwood Q4122 $101 [source] 4 years ago
Ascension St. Vincent Dunn 1600 23Rd St, Bedford Q4122 $101 [source] 4 years ago
Ascension St. Vincent Randolph 473 E Greenville Ave, Winchester Q4122 $101 [source] 4 years ago
Ascension St. Vincent Carmel 13500 N Meridian St, Carmel Q4122 $101 [source] 4 years ago
Ascension St. Vincent Anderson 2015 Jackson St, Anderson Q4122 $101 [source] 4 years ago
Ascension St. Vincent Heart Center 10580 N Meridian St, Indianapolis Q4122 $101 [source] 4 years ago
St. Vincent Clay Hospital, Inc 1206 E National Ave, Brazil Q4122 $6,012 [source] 4 years ago
Ascension St Vincent Fishers 13861 Olio Road, Q4122 $6,012 [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.