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
North Carolina
Hospital Address Code Price Last Updated
Adventhealth Hendersonville 100 Hospital Dr, Hendersonville Q4124 $4 [source] 4 years ago
Cone Health Moses Cone Hospital 1121 North Church St Entrance A, Greensboro Q4124 $11 [source] 4 years ago
Atrium Health University 8800 N. Tryon St. , Charlotte Q4124 $21 [source] 4 years ago
Carolinas Medical Center 1000 Blythe Blvd. , Charlotte Q4124 $21 [source] 4 years ago
Atrium Health Lincoln 433 Mcalister Road , Lincolnton Q4124 $21 [source] 4 years ago
Atrium Health Mercy 2001 Vail Ave. , Charlotte Q4124 $22 [source] 4 years ago
Atrium Health Pineville 10628 Park Road , Charlotte Q4124 $23 [source] 4 years ago
Atrium Health Cabarrus 920 Church Street North , Concord Q4124 $23 [source] 4 years ago
Atrium Health Union 600 Hospital Drive , Monroe Q4124 $26 [source] 4 years ago
Atrium Health Cleveland 201 E. Grover St. , Shelby Q4124 $30 [source] 4 years ago
Cone Health Penn Nursing Center 618 S Main St, Reidsville Q4124 $31 [source] 4 years ago
Cone Health Wesley Long Hospital 2400 W Friendly Ave, Greensboro Q4124 $31 [source] 4 years ago
Cone Health Alamance Regional Medical Center 1240 Huffman Mill Rd, Burlington Q4124 $31 [source] 4 years ago
Cone Health Behavioral Health Hospital 700 Walter Reed Dr, Greensboro Q4124 $31 [source] 4 years ago
Moses Cone Hospital 1131D N Church St, Greensboro Q4124 $31 [source] 4 years ago
Atrium Health Stanly 301 Yadkin St. , Albemarle Q4124 $32 [source] 4 years ago
Atrium Health Anson 2301 Us Hwy 74 W. , Wadesboro Q4124 $34 [source] 4 years ago
Carepartners Rehabilitation Hospital 68 Sweeten Creek Rd, Asheville Q4124 $9,329 [source] 4 years ago
Mcdowell Hospital , Marion Q4124 $10,075 [source] 4 years ago
Blue Ridge Regional Hospital 125 Hospital Dr, Spruce Pine Q4124 $10,075 [source] 4 years ago
Angel Medical Center 120 Riverview St, Franklin Q4124 $10,075 [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.