HCPCS Q4124

Oasis ultra tri-layer wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)

Current codeSkin Substitute Products38 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Other government program: TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

Prices for HCPCS Q4124 by hospital
Hospital	Other government program rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Valley HospitalArlington	—	$2,750 – $3,743	$3,438 – $4,679
EvergreenHealth Medical CenterKirkland	—	$102	$128
Highline Medical CenterBurienFile dated 2026-02-28	—	$4.38 – $602	$14.33 – $1,972
Skagit Valley HospitalMount Vernon	—	$2,750 – $3,743	$3,438 – $4,679
St Anthony HospitalGig HarborFile dated 2026-02-28	—	$4.36 – $600	$14.33 – $1,972
St Clare HospitalLakewoodFile dated 2026-02-28	—	$4.14 – $568	$14.33 – $1,972
St Elizabeth HospitalEnumclawFile dated 2026-02-28	—	$5.07 – $697	$14.33 – $1,972
St Francis Community HospitalFederal WayFile dated 2026-02-28	—	$4.50 – $619	$14.33 – $1,972
St Joseph Medical CenterTacomaFile dated 2026-02-28	—	$4.75 – $653	$14.33 – $1,972
St Michael Medical CenterSilverdaleFile dated 2026-02-28	—	$6.33 – $870	$14.33 – $1,972

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

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