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)
Florida
Hospital Address Code Price Last Updated
Adventhealth Waterman 1000 Waterman Way, Tavares Q4128 $56 [source] 4 years ago
Hialeah Hospital 651 East 25Th St., Hialeah Q4128 $94 [source] 4 years ago
Ocala Health 1431 Sw 1St Ave, Ocala Q4128 $129 [source] 4 years ago
Orange Park Medical Center 2001 Kingsley Avenue, Orange Park Q4128 $131 [source] 4 years ago
Adventhealth Dade City 13100 Fort King Rd, Dade City Q4128 $131 [source] 4 years ago
Florida Hospital North Pinellas 1395 S Pinellas Ave, Tarpon Springs Q4128 $148 [source] 4 years ago
Adventhealth Fish Memorial 1055 Saxon Blvd, Orange City Q4128 $178 [source] 4 years ago
Adventhealth Wesley Chapel 1127 Bruce B. Downs Blvd, Zephyrhills Q4128 $178 [source] 4 years ago
Adventhealth Zephyrhills 7050 Gall Blvd, Zephyrhills Q4128 $233 [source] 4 years ago
Adventhealth Deland 701 W. Plymouth Avenue, Deland Q4128 $433 [source] 4 years ago
North Florida Regional Medical Center 6500 W Newberry Rd, Gainesville Q4128 $844 [source] 4 years ago
Lakewood Ranch Medical Center 8330 Lakewood Ranch Boulevard, Bradenton Q4128 $1,747 [source] 4 years ago
Manatee Healthcare System 206 Second Street East, Bradenton Q4128 $1,747 [source] 4 years ago
Adventhealth Sebring 4200 Sun N Lake Blvd, Sebring Q4128 $1,756 [source] 4 years ago
Adventhealth Wauchula 735 S 5Th Ave, Wauchula Q4128 $1,756 [source] 4 years ago
Adventhealth New Smyrna Beach 401 Palmetto St, New Smyrna Beach Q4128 $6,212 [source] 4 years ago
Wellington Regional Medical Center 10101 Forest Hill Blvd., West Palm Beach Q4128 $10,629 [source] 4 years ago
Rmc Bayonet Point (Level Ii Trauma Center) 14000 Fivay Rd, Hudson Q4128 $11,661 [source] 4 years ago
Memorial Hospital 3625 University Blvd. S, Jacksonville Q4128 $11,671 [source] 4 years ago
Oak Hill Hospital 11375 Cortez Blvd, Brooksville Q4128 $13,784 [source] 4 years ago
South Bay Hospital 4016 Sun City Center Blvd, Sun City Center Q4128 $13,784 [source] 4 years ago
Adventhealth East Orlando 12301 Lake Underhill Rd Suite 219, Orlando Q4128 $15,731 [source] 4 years ago
Blake Medical Center 2020 59Th St West, Bradenton Q4128 $17,378 [source] 4 years ago
St. Petersburg General Hospital 6500 38Th Ave N, Saint Petersburg Q4128 $17,378 [source] 4 years ago
University Hospital & Medical Center 7201 North University Dr, Fort Lauderdale Q4128 $22,680 [source] 4 years ago
Florida Oncology Network Pa 7727 Lake Underhill Rd, Orlando Q4128 $28,044 [source] 4 years ago
Adventist Health System-Sunbelt Inc 2100 Ocoee Apopka Rd, Apopka Q4128 $28,601 [source] 4 years ago
Adventhealth Kissimmee 2501 N. Orange Ave, Orlando Q4128 $28,601 [source] 4 years ago
Adventhealth Winter Park 3099 Aloma Ave, Winter Park Q4128 $28,601 [source] 4 years ago
Adventhealth Celebration 400 Celebration Place Attn: Pharmacare Center Pharmacy , Kissimmee Q4128 $28,601 [source] 4 years ago
Adventhealth Tampa 3100 E Fletcher Ave, Tampa Q4128 $28,601 [source] 4 years ago
Adventhealth South Overland Park 10987 Sheldon Rd Ste 100, Tampa Q4128 $28,601 [source] 4 years ago
Citrus Memorial Hospital 502 W. Highland Blvd, Inverness Q4128 $29,385 [source] 4 years ago
Brandon Regional Hospital 119 Oakfield Dr, Brandon Q4128 $29,871 [source] 4 years ago
Gulf Coast Regional Medical Center 449 W 23Rd St, Panama City Q4128 $30,124 [source] 4 years ago
Mercy Miami Hospital 3663 S Miami Ave, Miami Q4128 $32,088 [source] 4 years ago
Northside Hospital 6000 49Th St North, Saint Petersburg Q4128 $32,850 [source] 4 years ago
Medical Center Of Trinity 9330 State Rd 54, New Port Richey Q4128 $35,953 [source] 4 years ago
Capital Regional Medical Center 2626 Capital Medical Blvd, Tallahassee Q4128 $41,472 [source] 4 years ago
Aventura Hospital & Medical Center 20900 Biscayne Blvd, Miami Q4128 $42,333 [source] 4 years ago
Doctors Hospital Of Sarasota 5731 Bee Ridge Rd, Sarasota Q4128 $43,590 [source] 4 years ago
Palms West Hospital 13001 Southern Blvd, Loxahatchee Q4128 $80,500 [source] 4 years ago
Jfk Medical Center - North Campus 2201 45Th St, West Palm Beach Q4128 $84,697 [source] 4 years ago
Kendall Regional Medical Center 11750 Sw 40 St, Miami Q4128 $89,600 [source] 4 years ago
St. Lucie Medical Center 1800 Se Tiffany Ave, Port Saint Lucie Q4128 $108,888 [source] 4 years ago
Plantation General Hospital 401 Nw 42 Ave, Fort Lauderdale Q4128 $114,923 [source] 4 years ago
Jfk Medical Center 5301 S Congress Ave, Lake Worth Q4128 $129,997 [source] 4 years ago
Lawnwood Medical Center & Heart Institute 1700 S 23Rd St, Fort Pierce Q4128 $132,300 [source] 4 years ago
Westside Regional Medical Center 8201 W Broward Blvd, Fort Lauderdale Q4128 $137,559 [source] 4 years ago
Northwest Medical Center 2801 North State Rd 7, Pompano Beach Q4128 $151,067 [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.