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
Florida
Hospital Address Code Price Last Updated
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q4124 $2 [source] 4 years ago
Gulf Coast Regional Medical Center 449 W 23Rd St, Panama City Q4124 $38 [source] 4 years ago
Memorial Hospital 3625 University Blvd. S, Jacksonville Q4124 $49 [source] 4 years ago
Central Florida Regional Hospital 1401 West Seminole Blvd, Sanford Q4124 $53 [source] 4 years ago
Adventhealth Waterman 1000 Waterman Way, Tavares Q4124 $313 [source] 4 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q4124 $1,794 [source] 4 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q4124 $1,794 [source] 4 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q4124 $2,183 [source] 4 years ago
University Hospital & Medical Center 7201 North University Dr, Fort Lauderdale Q4124 $2,530 [source] 4 years ago
Adventhealth Daytona Beach 301 Memorial Medical Pkwy, Daytona Beach Q4124 $2,557 [source] 4 years ago
Cleveland Clinic Florida - Weston 2950 Cleveland Clinic Boulevard, Fort Lauderdale Q4124 $2,587 [source] 4 years ago
Citrus Memorial Hospital 502 W. Highland Blvd, Inverness Q4124 $3,602 [source] 4 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4124 $3,972 [source] 4 years ago
Kendall Regional Medical Center 11750 Sw 40 St, Miami Q4124 $5,705 [source] 4 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q4124 $6,180 [source] 4 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q4124 $6,180 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4124 $6,180 [source] 4 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q4124 $6,180 [source] 4 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q4124 $6,180 [source] 4 years ago
Brandon Regional Hospital 119 Oakfield Dr, Brandon Q4124 $6,180 [source] 4 years ago
Palms Of Pasadena Hospital 1501 Pasadena Ave, Saint Petersburg Q4124 $6,180 [source] 4 years ago
Englewood Community Hospital 700 Medical Blvd, Englewood Q4124 $6,180 [source] 4 years ago
Largo Medical Center 201 14Th St Sw, Largo Q4124 $6,180 [source] 4 years ago
Memorial Hospital Of Tampa 2901 W. Swann Avenue, Tampa Q4124 $6,254 [source] 4 years ago
Oak Hill Hospital 11375 Cortez Blvd, Brooksville Q4124 $6,378 [source] 4 years ago
Jfk Medical Center 5301 S Congress Ave, Lake Worth Q4124 $6,746 [source] 4 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q4124 $7,223 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4124 $7,223 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4124 $7,223 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4124 $7,223 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4124 $7,223 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4124 $7,223 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4124 $7,223 [source] 4 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q4124 $11,777 [source] 4 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q4124 $11,777 [source] 4 years ago
Northwest Medical Center 2801 North State Rd 7, Pompano Beach Q4124 $11,777 [source] 4 years ago
Highlands Regional Medical Center 3600 South Highlands Ave, Sebring Q4124 $12,362 [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.