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
Michigan
Hospital Address Code Price Last Updated
St. John Providence 28000 Dequindre Rd, Warren Q4122 $95 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4122 $109 [source] 4 years ago
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q4122 $150 [source] 4 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q4122 $150 [source] 4 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q4122 $150 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4122 $166 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4122 $186 [source] 4 years ago
Midmichigan Medical Center Alpena , Alpena Q4122 $267 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre, Troy Q4122 $892 [source] 4 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak Q4122 $892 [source] 4 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak Q4122 $892 [source] 4 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy Q4122 $892 [source] 4 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak Q4122 $892 [source] 4 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak Q4122 $892 [source] 4 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak Q4122 $892 [source] 4 years ago
Botsford Continuing Care Corporation 21450 Archwood Cir, Farmington Q4122 $892 [source] 4 years ago
Botsford General Hospital 28050 Grand River Ave, Farmington Q4122 $892 [source] 4 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak Q4122 $892 [source] 4 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak Q4122 $892 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q4122 $892 [source] 4 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak Q4122 $892 [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.