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HCPCS Q4100

Skin substitute, not otherwise specified

Retired codeSkin Substitute Products29 hospitals with prices

Description from CMS's HCPCS Level II code file.

This code is retired. Some hospitals still list it.

What Washington hospitals publish for this code

Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.

HospitalMedicare Advantage rates (lowest – highest)Cash priceList price (before discounts)
Cascade Valley HospitalArlington$2,841 – $11,4201 plan$2,272 – $9,136$2,841 – $11,420
Harborview Medical CenterSeattleFile dated 2026-04-01—$16.75 – $12,794$23.93 – $18,277
Highline Medical CenterBurienFile dated 2026-02-28—$1,301 – $7,956$4,259 – $26,055
Kadlec Regional Medical CenterRichlandFile dated 2026-04-01—$568 – $21,510$811 – $30,729
Prov Sacred HRT Med Ctr & Childs Hosp.SpokaneFile dated 2026-04-01—$458 – $27,141$655 – $38,773
Providence Centralia HospitalCentraliaFile dated 2026-04-01—$486 – $24,465$934 – $47,049
Providence Holy Family HospitalSpokaneFile dated 2026-04-01—$458 – $27,141$655 – $38,773
Providence Mount Carmel HospitalColvilleFile dated 2026-04-01—$434 – $26,039$620 – $37,198
Providence Regional Medical Center EverettEverettFile dated 2026-04-01—$537 – $35,933$1,033 – $69,103
Providence St Joseph HospitalChewelahFile dated 2026-04-01—$434 – $26,039$620 – $37,198
Providence St Mary Medical CenterWalla WallaFile dated 2026-04-01—$378 – $24,804$539 – $35,434
Providence St Peter HospitalOlympiaFile dated 2026-04-01—$486 – $24,465$934 – $47,049
Skagit Valley HospitalMount Vernon—$2,272 – $9,136$2,841 – $11,420
St Anthony HospitalGig HarborFile dated 2026-02-28—$1,295 – $7,925$4,259 – $26,055
St Clare HospitalLakewoodFile dated 2026-02-28—$1,228 – $7,510$4,259 – $26,055
St Elizabeth HospitalEnumclawFile dated 2026-02-28—$1,505 – $9,207$4,259 – $26,055
St Francis Community HospitalFederal WayFile dated 2026-02-28—$1,337 – $8,177$4,259 – $26,055
St Joseph Medical CenterTacomaFile dated 2026-02-28—$1,411 – $8,629$4,259 – $26,055
St Michael Medical CenterSilverdaleFile dated 2026-02-28—$1,880 – $11,499$4,259 – $26,055
Swedish Edmonds HospitalEdmondsFile dated 2026-04-01—$333 – $28,229$693 – $58,811
Swedish IssaquahIssaquahFile dated 2026-04-01—$579 – $28,229$1,206 – $58,811
Swedish Medical CenterSeattleFile dated 2026-04-01—$333 – $28,229$693 – $58,811
Swedish Medical Center / Cherry HillSeattleFile dated 2026-04-01—$333 – $28,229$693 – $58,811
Tacoma General Allenmore HospitalTacomaFile dated 2026-08-27—$784$1,961
University of Washington Medical CtrSeattleFile dated 2026-04-01—$14.50 – $11,372$20.71 – $16,246
Virginia Mason Medical CenterSeattle—$38.76 – $8,964$76.00 – $17,576

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.