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
Tennessee
Hospital Address Code Price Last Updated
Riverview Regional Medical Center 158 Hospital Drive, Carthage Q4122 $41 [source] 4 years ago
Trousdale Medical Center 500 Church Street, Hartsville Q4122 $216 [source] 4 years ago
Saint Thomas River Park Hospital, Llc 120 Walnut Commons Ln Ste D, Cookeville Q4122 $247 [source] 4 years ago
Ascension Saint Thomas Stones River 324 Doolittle Rd, Woodbury Q4122 $247 [source] 4 years ago
Ascension Saint Thomas Dekalb 520 W Main St, Smithville Q4122 $247 [source] 4 years ago
Saint Thomas Hickman Hospital 1518 Highway 100, Centerville Q4122 $247 [source] 4 years ago
Ascension Saint Thomas Highlands 401 Sewell Dr, Sparta Q4122 $247 [source] 4 years ago
Sumner Regional Medical Center 555 Hartsville Pike, Gallatin Q4122 $404 [source] 4 years ago
Southern Tennessee Regional Health System - Lawrenceburg 1607 South Locust Avenue, Lawrenceburg Q4122 $17,460 [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.