Code: Q4128

Description:
Description: Flex hd, allopatch hd, or matrix hd, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
Other Descriptions:
ALLOPATCH PLIABLE 2.0CM X 2.0CM
ALLOPATCH PLIABLE, THIN, PER SQ CM, 2.0 X 2.0CM
MESH FLEXHD 17X10CM 7-1.4MM
GRAFT DERMAL 0.8-1.7MM 20X20CM
GRAFT DERM ULTRATHCK 25X20CM
GRAFT DERMAL 12X12CM FLEX HD
GRAFT DERMAL 8X12CM FLEX HD
GRAFT DERMAL 8X16CM FLEX HD
DERMAL 2X1CMX0.4-0.8MM FLEX HD
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: Q4126
DERMASPAN 25 SQ CM
Code: Q4127
Description: Talymed, per square centimeter
HCPCS Category: Temporary codes (limited use and guidelines specific)
California
Hospital Address Code Price Last Updated
West Hills Hospital 7300 Medical Center Dr, West Hills Q4128 $705 [source] 4 years ago
Riverside Community Hospital 4445 Magnolia Ave, Riverside Q4128 $781 [source] 4 years ago
Regional Medical Center Of San Jose 225 North Jackson Ave, San Jose Q4128 $957 [source] 4 years ago
Los Robles Regional Medical Center 215 West Janss Rd, Thousand Oaks Q4128 $1,106 [source] 4 years ago
Corona Regional Medical Center 800 S. Main Street, Corona Q4128 $2,870 [source] 4 years ago
Inland Valley Medical Center 36485 Inland Valley Drive, Wildomar Q4128 $3,052 [source] 4 years ago
Rancho Springs Medical Center 25500 Medical Center Drive, Murrieta Q4128 $3,052 [source] 4 years ago
Sutter Medical Center Of Sacramento 2825 Capitol Avenue, Sacramento Q4128 $6,521 [source] 4 years ago
California Pacific Medical Center - Davies Campus 45 Castro St, San Francisco Q4128 $7,493 [source] 4 years ago
Sutter Santa Rosa Regional Hospital 30 Mark West Springs Rd, Santa Rosa Q4128 $7,905 [source] 4 years ago
Sutter Tracy Community Hospital 1420 N Tracy Blvd, Tracy Q4128 $8,947 [source] 4 years ago
South San Francisco Medical Center 1200 El Camino Real, South San Francisco Q4128 $9,000 [source] 4 years ago
Kaiser Foundation Hospitals 4501 Sand Creek Road, Antioch Q4128 $9,000 [source] 4 years ago
Sacramento Medical Center 2025 Morse Ave, Sacramento Q4128 $9,000 [source] 4 years ago
Oakland Medical Center 3600 Broadway, Woodland Hills Q4128 $9,000 [source] 4 years ago
Modesto Medical Center 4601 Dale Rd, Modesto Q4128 $9,000 [source] 4 years ago
Vacaville Medical Center 1 Quality Dr, Vacaville Q4128 $9,000 [source] 4 years ago
San Leandro Medical Center 2500 Merced St, San Leandro Q4128 $9,000 [source] 4 years ago
Walnut Creek Medical Center 1425 S Main St, Walnut Creek Q4128 $9,000 [source] 4 years ago
Santa Clara Medical Center 700 Lawrence Expy, Santa Clara Q4128 $9,000 [source] 4 years ago
South Sacramento Medical Center 6600 Bruceville Rd, Sacramento Q4128 $9,000 [source] 4 years ago
Richmond Medical Center 901 Nevin Ave, Richmond Q4128 $9,000 [source] 4 years ago
Santa Rosa Medical Center 401 Bicentennial Way, American Canyon Q4128 $9,000 [source] 4 years ago
Redwood City Medical Center 1100 Veterans Blvd, Redwood City Q4128 $9,000 [source] 4 years ago
Vallejo Medical Center 975 Sereno Dr, Vallejo Q4128 $9,000 [source] 4 years ago
San Rafael Medical Center 99 Montecillo Rd, San Rafael Q4128 $9,000 [source] 4 years ago
San Francisco Medical Center 2525 Geary Blvd, San Francisco Q4128 $9,000 [source] 4 years ago
Fresno Medical Center 39400 Paseo Padre Pkwy, Fresno Q4128 $9,000 [source] 4 years ago
Roseville Medical Center 1600 Eureka Rd, Roseville Q4128 $9,000 [source] 4 years ago
San Jose Medical Center 250 Hospital Pkwy, San Jose Q4128 $9,000 [source] 4 years ago
Temecula Valley Hospital 31700 Temecula Parkway, Temecula Q4128 $9,956 [source] 4 years ago
Sutter Roseville Medical Center 1 Medical Plaza Dr, Roseville Q4128 $14,254 [source] 4 years ago
Sutter Auburn Faith Hospital 11815 Education St, Auburn Q4128 $14,254 [source] 4 years ago
Alta Bates Summit Medical Center - Summit Campus 3100 Summit Street, Oakland Q4128 $17,000 [source] 4 years ago
Palmdale Regional Medical Center 38600 Medical Center Drive, Palmdale Q4128 $18,474 [source] 4 years ago
Sutter Maternity And Surgery Center, Santa Cruz 2900 Chanticleer Ave, Santa Cruz Q4128 $26,845 [source] 4 years ago
Sutter Maternity And Surgery Center Of Santa Cruz 2900 Chanticleer Avenue, Santa Cruz Q4128 $26,845 [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.