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
Michigan
Hospital Address Code Price Last Updated
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q4124 $10 [source] 4 years ago
Beaumont - Farmington Hills 28050 Grand River Ave, Farmington Q4124 $10 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q4124 $11 [source] 4 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q4124 $11 [source] 4 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q4124 $11 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren Q4124 $15 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4124 $17 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4124 $25 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4124 $28 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q4124 $30 [source] 4 years ago
Mclaren Lapeer Region 1375 N Main St, Lapeer Q4124 $36 [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.