Code: Q4124

Description:
Description: Oasis ultra tri-layer wound matrix, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
OASIS TRI-LAYER 1SQCM
Drsg Oasis Tri-layer Per Sq Cm
DRESSING OASIS ULTRA PORCINE SMALL INTESTINE SUBMUCOSA 10X7CM BIOLOGICAL 3
DRESSING OASIS ULTRA PORCINE SMALL INTESTINE SUBMUCOSA 7X5CM BIOLOGICAL 3
CATHETER FOGARTY 6FR COIL 50CM THROMBECTOMY GRAFT FLEXIBLE CLOT MANAGEMENT
OASIS TRI LYR 35 PER SQCM
OASIS ULTRA TRI-LAYER MATRIX, PER SQ CM, 3 X 7CM PAD
OASIS ULTRA TRI-LAYER MATRIX, PER SQ CM, 3 X 3.5CM PAD
OASIS ULTRA TRI-LAYER MATRIX, PER SQ CM, 5 X 7CM PAD
Related codes:
Code: Q4120
Code: Q4121
THERASKIN 6SQCM
Code: Q4122
DERMACELLAWMPORO 1SQCM
Code: Q4123
ALLOSKIN RT 1SQCM
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
State Average # Hospitals In Database
Minnesota (MN) $12 1
New Jersey (NJ) $13 1
Mississippi (MS) $17 2
Oklahoma (OK) $17 1
Michigan (MI) $18 11
Delaware (DE) $25 1
Maine (ME) $29 1
Alabama (AL) $39 4
Kansas (KS) $40 4
Wisconsin (WI) $41 11
Rhode Island (RI) $42 1
Virginia (VA) $51 1
Missouri (MO) $63 3
Idaho (ID) $102 2
Tennessee (TN) $106 9
Kentucky (KY) $192 4
California (CA) $432 27
West Virginia (WV) $492 4
Maryland (MD) $687 5
Indiana (IN) $946 14
New York (NY) $1,084 1
District of Columbia (DC) $1,293 1
Louisiana (LA) $1,357 2
New Hampshire (NH) $1,395 3
Massachusetts (MA) $1,646 14
Texas (TX) $2,272 24
Ohio (OH) $2,459 10
Georgia (GA) $2,761 3
Nevada (NV) $2,827 5
North Carolina (NC) $2,925 24
Florida (FL) $5,030 54

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.