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
Massachusetts
Hospital Address Code Price Last Updated
Spaulding Rehab Hospital Boston 300 1St Ave, Charlestown Q4125 $2,523 [source] 4 years ago
Martha's Vineyard Hospital One Hospital Road, Oak Bluffs Q4125 $2,944 [source] 4 years ago
Spaulding Hospital Cambridge 1575 Cambridge St, Cambridge Q4125 $2,944 [source] 4 years ago
Spaulding Rehab Hospital Cape Cod 311 Service Rd, East Sandwich Q4125 $2,944 [source] 4 years ago
Cooley Dickinson Health Care 30 Locust St, Northampton Q4125 $2,944 [source] 4 years ago
Nantucket Cottage Hospital 57 Prospect St, Nantucket Q4125 $2,944 [source] 4 years ago
Mclean Hospital 115 Mill St, Belmont Q4125 $2,944 [source] 4 years ago
Massachusetts Eye And Ear 243 Charles St, Boston Q4125 $2,944 [source] 4 years ago
Brigham & Womens Hospital, Inc. 75 Francis St, Boston Q4125 $2,944 [source] 4 years ago
Brigham & Women Faulkner Hospital 1153 Centre St, Jamaica Plain Q4125 $5,530 [source] 4 years ago
Newton Wellesley Hospital 2014 Washington St, Newton Lower Falls Q4125 $7,612 [source] 4 years ago
North Shore Medical Center Hospital 81 Highland Ave, Salem Q4125 $8,320 [source] 4 years ago
Massachusetts General Hospital 55 Fruit St, Boston Q4125 $9,515 [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.