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)
Michigan
Hospital Address Code Price Last Updated
Up Health System – Marquette 580 West College Avenue, Marquette Q4128 $73 [source] 4 years ago
Mclaren Macomb 1000 Harrington St, Mount Clemens Q4128 $77 [source] 4 years ago
Karmanos Cancer Institute 4100 John R St, Detroit Q4128 $134 [source] 4 years ago
William Beaumont Hospital 468 Cadieux Rd, Grosse Pointe Q4128 $417 [source] 4 years ago
St. John Providence 28000 Dequindre Rd, Warren Q4128 $584 [source] 4 years ago
Ascension Providence Rochester Hospital 1101 W University Dr, Rochester Q4128 $671 [source] 4 years ago
Providence Hospital And Medical Centers 16001 W 9 Mile Rd, Southfield Q4128 $1,016 [source] 4 years ago
St. John Macomb Oakland Hospital-Warren Campus 11800 E 12 Mile Rd, Warren Q4128 $1,140 [source] 4 years ago
Beaumont - Farmington Hills 28050 Grand River Ave, Farmington Q4128 $5,097 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre, Troy Q4128 $14,438 [source] 4 years ago
Beaumont Ashn, Llc 1919 Technology Dr Ste B, Troy Q4128 $14,438 [source] 4 years ago
William Beaumont Hospital 44201 Dequindre Rd, Troy Q4128 $14,438 [source] 4 years ago
William Beaumont Hospital 3555 W 13 Mile Rd, Royal Oak Q4128 $16,698 [source] 4 years ago
William Beaumont Hospital 10000 Telegraph Rd, Taylor Q4128 $16,698 [source] 4 years ago
Mclaren Flint 401 S Ballenger Hwy, Flint Q4128 $32,919 [source] 4 years ago
William Beaumont Hospital 4949 Coolidge Hwy, Royal Oak Q4128 $202,672 [source] 4 years ago
William Beaumont Hospital 5150 Coolidge Hwy, Royal Oak Q4128 $202,672 [source] 4 years ago
William Beaumont Hospital 3535 W 13 Mile Rd, Royal Oak Q4128 $202,672 [source] 4 years ago
Beaumont Health System 3601 W. 13 Mile Rd, Royal Oak Q4128 $202,672 [source] 4 years ago
Beaumont Orthopaedic Center 3535 W 13 Mile Road, Royal Oak Q4128 $202,672 [source] 4 years ago
Beaumont Special Radiological Procedures 3601 W Thirteen Mile Rd, Royal Oak Q4128 $202,672 [source] 4 years ago
William Beaumont Hospital 1026 Eleven Mile Road, Royal Oak Q4128 $202,672 [source] 4 years ago
William Beaumont Hospital 3601 W 13 Mile Rd, Royal Oak Q4128 $202,672 [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.