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)
Massachusetts
Hospital Address Code Price Last Updated
Martha's Vineyard Hospital One Hospital Road, Oak Bluffs Q4128 $277 [source] 4 years ago
Saint Vincent Hospital 123 Summer St., Worcester Q4128 $1,034 [source] 4 years ago
Newton Wellesley Hospital 2014 Washington St, Newton Lower Falls Q4128 $1,958 [source] 4 years ago
Cooley Dickinson Health Care 30 Locust St, Northampton Q4128 $2,284 [source] 4 years ago
Mclean Hospital 115 Mill St, Belmont Q4128 $2,284 [source] 4 years ago
North Shore Medical Center Hospital 81 Highland Ave, Salem Q4128 $4,240 [source] 4 years ago
Spaulding Rehab Hospital Boston 300 1St Ave, Charlestown Q4128 $4,240 [source] 4 years ago
Nantucket Cottage Hospital 57 Prospect St, Nantucket Q4128 $4,995 [source] 4 years ago
Spaulding Rehab Hospital Cape Cod 311 Service Rd, East Sandwich Q4128 $7,118 [source] 4 years ago
Massachusetts Eye And Ear 243 Charles St, Boston Q4128 $7,118 [source] 4 years ago
Massachusetts General Hospital 55 Fruit St, Boston Q4128 $11,574 [source] 4 years ago
Brigham & Womens Hospital, Inc. 75 Francis St, Boston Q4128 $12,497 [source] 4 years ago
Brigham & Women Faulkner Hospital 1153 Centre St, Jamaica Plain Q4128 $37,586 [source] 4 years ago
Spaulding Hospital Cambridge 1575 Cambridge St, Cambridge Q4128 $42,488 [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.