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
Massachusetts
Hospital Address Code Price Last Updated
Spaulding Hospital Cambridge 1575 Cambridge St, Cambridge Q4124 $44 [source] 4 years ago
Spaulding Rehab Hospital Cape Cod 311 Service Rd, East Sandwich Q4124 $44 [source] 4 years ago
Cooley Dickinson Health Care 30 Locust St, Northampton Q4124 $44 [source] 4 years ago
Nantucket Cottage Hospital 57 Prospect St, Nantucket Q4124 $44 [source] 4 years ago
Brigham & Women Faulkner Hospital 1153 Centre St, Jamaica Plain Q4124 $44 [source] 4 years ago
Newton Wellesley Hospital 2014 Washington St, Newton Lower Falls Q4124 $44 [source] 4 years ago
North Shore Medical Center Hospital 81 Highland Ave, Salem Q4124 $2,655 [source] 4 years ago
Spaulding Rehab Hospital Boston 300 1St Ave, Charlestown Q4124 $2,655 [source] 4 years ago
Brigham & Womens Hospital, Inc. 75 Francis St, Boston Q4124 $2,817 [source] 4 years ago
Martha's Vineyard Hospital One Hospital Road, Oak Bluffs Q4124 $3,098 [source] 4 years ago
Massachusetts General Hospital 55 Fruit St, Boston Q4124 $3,098 [source] 4 years ago
Massachusetts Eye And Ear 243 Charles St, Boston Q4124 $3,098 [source] 4 years ago
Mclean Hospital 115 Mill St, Belmont Q4124 $5,310 [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.