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)
Texas
Hospital Address Code Price Last Updated
Northwest Texas Healthcare System 1501 S. Coulter, Amarillo Q4128 $367 [source] 4 years ago
Texas Health Huguley 11801 South Fwy, Burleson Q4128 $388 [source] 4 years ago
Medical City Frisco 5500 Frisco Square Blvd, Frisco Q4128 $518 [source] 4 years ago
Medical City Weatherford 713 E Anderson St, Weatherford Q4128 $555 [source] 4 years ago
Medical City Las Colinas 6800 N Macarthur Blvd, Irving Q4128 $636 [source] 4 years ago
Medical City Fort Worth 900 8Th Ave, Fort Worth Q4128 $643 [source] 4 years ago
Medical City Lewisville 500 W Main St, Lewisville Q4128 $698 [source] 4 years ago
Texoma Medical Center 5016 South Us Highway 75, Denison Q4128 $1,074 [source] 4 years ago
Medical City Arlington 3301 Matlock Rd, Arlington Q4128 $1,211 [source] 4 years ago
Adventhealth Central Texas 2201 Clear Creek Rd, Killeen Q4128 $1,337 [source] 4 years ago
Adventhealth Rollins Brook 608 N Key Ave, Lampasas Q4128 $1,337 [source] 4 years ago
Medical City North Hills 4401 Booth Calloway Rd, North Richland Hills Q4128 $4,928 [source] 4 years ago
Fort Duncan Regional Medical Center 3333 N. Foster Maldonado Blvd., Eagle Pass Q4128 $6,550 [source] 4 years ago
Doctors Hospital Of Laredo 10700 Mcpherson Road, Laredo Q4128 $6,622 [source] 4 years ago
South Texas Health System Mcallen 301 W. Expressway 83, Mcallen Q4128 $7,770 [source] 4 years ago
South Texas Health System Heart 1900 South D Street, Mcallen Q4128 $7,770 [source] 4 years ago
South Texas Health System Children’s 1102 W. Trenton Road, Edinburg Q4128 $7,770 [source] 4 years ago
Northeast Baptist Hospital 8811 Village Dr., San Antonio Q4128 $11,499 [source] 4 years ago
St. Luke's Baptist Hospital 7930 Floyd Curl Dr., San Antonio Q4128 $11,499 [source] 4 years ago
Baptist Medical Center 111 Dallas St., San Antonio Q4128 $11,499 [source] 4 years ago
Mission Trail Baptist Hospital 3333 Research Plaza, San Antonio Q4128 $11,499 [source] 4 years ago
North Central Baptist Hospital 520 Madison Oak Dr., San Antonio Q4128 $11,499 [source] 4 years ago
Medical City Alliance 3101 N Tarrant Pkwy, Fort Worth Q4128 $15,897 [source] 4 years ago
Hca Houston Healthcare 3737 Buffalo Speedway Suite 140, Houston Q4128 $16,350 [source] 4 years ago
Valley Regional Medical Center 100-A Alton Gloor Blvd, Brownsville Q4128 $33,914 [source] 4 years ago
Medical City Denton 3535 S Interstate 35, Corinth Q4128 $37,637 [source] 4 years ago
Woman's Hospital Of Texas 7600 Fannin, Houston Q4128 $42,631 [source] 4 years ago
Medical City Dallas 13155 Noel Rd. Suite 200, Dallas Q4128 $71,402 [source] 4 years ago
Rio Grande Regional Hospital 101 East Ridge Road, Mcallen Q4128 $100,000 [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.