Code: Q4126

Description:
Description: Memoderm, dermaspan, tranzgraft or integuply, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
MEMODERM 25 SQ CM
MEMODERM 32 SQ CM
MEMODERM 50 SQ CM
DERMASPAN 25SQCM
MEMODDERMTRZINT 1SQCM
DERMASPAN 0.8-1.4 5X5CM
DERMASPAN 4X8CM 0.70MM
DERMASPAN 0.9-1.99 5X10CM
DERMASPAN 0.9-1.99 6X12CM
Related codes:
Code: Q4120
Code: Q4121
THERASKIN 6SQCM
Code: Q4122
DERMACELLAWMPORO 1SQCM
Code: Q4123
ALLOSKIN RT 1SQCM
Code: Q4124
OASIS TRI MATRIX 35SQCM
Code: Q4125
ARTHROFLX 12SQCM .5M THK
Code: Q4127
Description: Talymed, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Code: Q4128
FLEXALLOPMATR HD 1SQCM
Florida
Hospital Address Code Price Last Updated
Adventhealth Waterman 1000 Waterman Way, Tavares Q4126 $111 [source] 4 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q4126 $146 [source] 4 years ago
West Florida Hospital 8383 N Davis Hwy, Pensacola Q4126 $179 [source] 4 years ago
Orange Park Medical Center 2001 Kingsley Avenue, Orange Park Q4126 $289 [source] 4 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q4126 $458 [source] 4 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q4126 $458 [source] 4 years ago
Ocala Health 1431 Sw 1St Ave, Ocala Q4126 $566 [source] 4 years ago
Adventhealth New Smyrna Beach 401 Palmetto St, New Smyrna Beach Q4126 $1,315 [source] 4 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q4126 $2,904 [source] 4 years ago
Fort Walton Beach Medical Center 1000 Mar Walt Dr, Fort Walton Beach Q4126 $4,935 [source] 4 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4126 $6,266 [source] 4 years ago
Oak Hill Hospital 11375 Cortez Blvd, Brooksville Q4126 $6,767 [source] 4 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q4126 $6,890 [source] 4 years ago
Citrus Memorial Hospital 502 W. Highland Blvd, Inverness Q4126 $6,890 [source] 4 years ago
Fawcett Memorial Hospital 21298 Olean Blvd, Port Charlotte Q4126 $6,890 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4126 $6,890 [source] 4 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q4126 $8,063 [source] 4 years ago
Largo Medical Center 201 14Th St Sw, Largo Q4126 $8,920 [source] 4 years ago
Poinciana Medical Center 325 Cypress Pkwy, Kissimmee Q4126 $10,035 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4126 $11,393 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4126 $11,393 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4126 $11,393 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4126 $11,393 [source] 4 years ago
Adventhealth Winter Garden 10987 Sheldon Rd Ste 100, Tampa Q4126 $11,393 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4126 $11,393 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4126 $11,393 [source] 4 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q4126 $11,752 [source] 4 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q4126 $14,700 [source] 4 years ago
Plantation General Hospital 401 Nw 42 Ave, Fort Lauderdale Q4126 $15,474 [source] 4 years ago
St. Lucie Medical Center 1800 Se Tiffany Ave, Port Saint Lucie Q4126 $17,010 [source] 4 years ago
Highlands Regional Medical Center 3600 South Highlands Ave, Sebring Q4126 $19,810 [source] 4 years ago
Jfk Medical Center - North Campus 2201 45Th St, West Palm Beach Q4126 $22,400 [source] 4 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q4126 $44,645 [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.