Code: Q4125

Description:
Description: Arthroflex, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
ARTHROFLEX 28 SQ CM 1THK
ARTHROFLEX 28 SQ CM 2THK
ARTHROFLEX 45 SQ CM
ARTHROFLEX 40X70MM 3THK
ARTHROFLEX 1 SQ CM
GRAFT ARTHROFLEX FLEXIGRAFT DERMIS 35X35X1.26-1.75MM SOFT TISSUE PATCH
GRAFT ARTHROFLEX FLEXIGRAFT DERMIS 40X70X1.26-1.75MM SOFT TISSUE PATCH
GRAFT DERMIS 70X40X2MM SOFT TISSUE DECELLULARIZED LATEX FREE
GRAFT ARTHROFLEX THK.76-1.25MM DECELLULARIZED DERMIS 70X40MM SOFT TISSUE
Related codes:
Code: Q4120
Code: Q4121
THERASKIN 6SQCM
Code: Q4122
DERMACELLAWMPORO 1SQCM
Code: Q4123
ALLOSKIN RT 1SQCM
Code: Q4124
OASIS TRI MATRIX 35SQCM
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
California
Hospital Address Code Price Last Updated
Placentia - Linda Hospital 1301 N. Rose Dr., Placentia Q4125 $278 [source] 4 years ago
Cedars-Sinai Medical Center 8700 Beverly Blvd, Los Angeles Q4125 $1,375 [source] 4 years ago
Riverside Community Hospital 4445 Magnolia Ave, Riverside Q4125 $1,660 [source] 4 years ago
Los Robles Regional Medical Center 215 West Janss Rd, Thousand Oaks Q4125 $1,975 [source] 4 years ago
West Hills Hospital 7300 Medical Center Dr, West Hills Q4125 $2,268 [source] 4 years ago
Stanislaus Surgical Hospital 1421 Oakdale Rd, Modesto Q4125 $2,542 [source] 4 years ago
Inland Valley Medical Center 36485 Inland Valley Drive, Wildomar Q4125 $3,046 [source] 4 years ago
Rancho Springs Medical Center 25500 Medical Center Drive, Murrieta Q4125 $3,046 [source] 4 years ago
Corona Regional Medical Center 800 S. Main Street, Corona Q4125 $3,307 [source] 4 years ago
Temecula Valley Hospital 31700 Temecula Parkway, Temecula Q4125 $3,950 [source] 4 years ago
Palmdale Regional Medical Center 38600 Medical Center Drive, Palmdale Q4125 $4,470 [source] 4 years ago
Sutter Solano Medical Center 300 Hospital Dr, Vallejo Q4125 $6,342 [source] 4 years ago
Sutter Medical Center Of Sacramento 2825 Capitol Avenue, Sacramento Q4125 $8,760 [source] 4 years ago
Sutter Delta Medical Center 3901 Lone Tree Way, Antioch Q4125 $11,278 [source] 4 years ago
Sutter Health Memorial Medical Center 1700 Coffee Rd, Modesto Q4125 $11,278 [source] 4 years ago
Sutter Santa Rosa Regional Hospital 30 Mark West Springs Rd, Santa Rosa Q4125 $11,278 [source] 4 years ago
Sutter Roseville Medical Center 1 Medical Plaza Dr, Roseville Q4125 $12,250 [source] 4 years ago
Sutter Auburn Faith Hospital 11815 Education St, Auburn Q4125 $12,250 [source] 4 years ago
Sutter Maternity And Surgery Center Of Santa Cruz 2900 Chanticleer Avenue, Santa Cruz Q4125 $12,639 [source] 4 years ago
Sutter Maternity And Surgery Center, Santa Cruz 2900 Chanticleer Ave, Santa Cruz Q4125 $12,639 [source] 4 years ago
California Pacific Medical Center - Mission Bernal Campus 3555 Cesar Chavez, San Francisco Q4125 $13,028 [source] 4 years ago
Mills-Peninsula Medical Center 1501 Trousdale Dr, Burlingame Q4125 $13,223 [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.