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
Missouri
Hospital Address Code Price Last Updated
Saint Luke’s North Hospital 5830 Nw Barry Rd, Kansas City Q4125 $262 [source] 4 years ago
Saint Luke’s Hospital 4401 Wornall Rd, Kansas City Q4125 $332 [source] 4 years ago
Research Medical Center 2316 E Meyer Blvd, Kansas City Q4125 $458 [source] 4 years ago
Belton Regional Medical Center 17065 S. 71 Highway, Belton Q4125 $5,950 [source] 4 years ago
Lee's Summit Medical Center 2100 Se Blue Parkway, Lees Summit Q4125 $9,625 [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 §180.