HCPCS Q4122
Dermacell, dermacell awm or dermacell awm porous, per square centimeter (add-on, list separately in addition to primary procedure)
Current codeSkin Substitute Products38 hospitals with prices
What Washington hospitals publish for this code
Medicare Advantage: Rate for a private Medicare Advantage plan. Applies only to members of that plan.
| Hospital | Medicare Advantage rates (lowest – highest) | Cash price | List price (before discounts) |
|---|---|---|---|
| Capital Medical Center | $141 – $155 | $17,884 | $44,709 |
| Deaconess Medical Center | $136 – $149 | $17,884 | $44,709 |
| Harborview Medical Center | $144 – $159 | — | — |
| Highline Medical Center | — | $673 – $15,271 | $2,203 – $50,011 |
| Island Hospital | $149 – $157 | — | — |
| Kadlec Regional Medical Center | $139 – $166 | $4,135 | $5,907 |
| Legacy Salmon Creek Medical Center | $143 – $155 | $102 | $157 |
| Mary Bridge Children's Hospital | $142 – $157 | $17,884 | $44,709 |
| MultiCare Auburn Medical Center | $142 – $156 | $17,884 | $44,709 |
| MultiCare Covington Medical Center | $142 – $156 | $17,884 | $44,709 |
| MultiCare Good Samaritan Hospital | $142 – $157 | $17,884 | $44,709 |
| MultiCare Valley Hospital | $140 – $149 | $17,884 | $44,709 |
| Olympic Medical Center | $156 – $201 | — | — |
| Overlake Hospital Medical Center & Clinics | $145 – $150 | — | — |
| PeaceHealth St Joseph Medical Center | $127 – $139 | $6,527 | $10,042 |
| Prov Sacred HRT Med Ctr & Childs Hosp. | $139 – $166 | $5,314 | $7,591 |
| Providence Centralia Hospital | $144 – $231 | $8,665 | $16,663 |
| Providence Holy Family Hospital | $139 – $153 | $5,314 | $7,591 |
| Providence Mount Carmel Hospital | — | $5,076 | $7,251 |
| Providence Regional Medical Center Everett | $142 – $156 | $7,591 | $14,599 |
| Providence St Joseph Hospital | — | $5,076 | $7,251 |
| Providence St Mary Medical Center | — | $4,605 | $6,579 |
| Providence St Peter Hospital | — | $8,665 | $16,663 |
| St Anthony Hospital | — | $670 – $15,211 | $2,203 – $50,011 |
| St Clare Hospital | — | $635 – $14,415 | $2,203 – $50,011 |
| St Elizabeth Hospital | $397 – $11,002 | $778 – $17,672 | $2,203 – $50,011 |
| St Francis Community Hospital | — | $691 – $15,695 | $2,203 – $50,011 |
| St Joseph Medical Center | — | $730 – $16,563 | $2,203 – $50,011 |
| St Michael Medical Center | — | $972 – $22,072 | $2,203 – $50,011 |
| Swedish Edmonds Hospital | $142 – $170 | $5,152 | $10,733 |
| Swedish Issaquah | $145 – $173 | $5,152 | $10,733 |
| Swedish Medical Center | $144 – $173 | $5,152 | $10,733 |
| Swedish Medical Center / Cherry Hill | $144 – $173 | $5,152 | $10,733 |
| Tacoma General Allenmore Hospital | $142 – $157 | $17,884 | $44,709 |
| University of Washington Medical Ctr | $144 – $159 | — | — |
| Virginia Mason Medical Center | — | — | — |
| Wellfound Behavioral Health Hospital | — | — | — |
| Yakima Valley Memorial | $146 – $163 | — | — |
Medicare (traditional) reference
Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.
- Doctor's fee, Seattle (King County)
- $156 in an office; $156 in a hospital or surgery center
- Doctor's fee, rest of Washington
- $134 in an office; $134 in a hospital or surgery center
- Hospital outpatient payment (national)
- $127 (APC 6001)
- Surgery center payment (national)
- $127