Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
DERMIS PATCH DECELLULARIZED 30X40MM THICKNESS ARTH
Prices here combine facility and professional fees. See them separately →Experimental
Low
$0
Average
$1.9k
Median
$229
High
$20.3k
Filter by billing methodology
Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 222 hospitals; the 90th percentile is 51.9× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Virtua_Memorial_Hospital_Inc | Mount Holly, NJ | $20.3k | $20.3k | — | — | 6–60 | $20.3k – $20.3k |
| 2 | University of Virginia Medical Center Charlottesville, VA | $125 | $170 | $94 | 55% | 2–20 | $112 – $373 |
| 3 | Commonspirit Kansas, Inc. Garden City, KS | $40 | $40 | — | — | 1–10 | $40 – $40 |
| 4 | University of Virginia Haymarket Medical Center Haymarket, VA | $129 | $184 | $95 | 51% | — | $129 – $360 |
| 5 | SwedishAmerican Hospital Rockford, IL | $135 | $135 | $5 | 4% | — | $130 – $140 |
| 6 | Laird Hospital, Inc. Union, MS | $3.2k | $3.9k | $1.7k | 43% | — | $1.8k – $8.9k |
| 7 | Progress West Hospital O'Fallon, MO | $125 | $126 | $3 | 2% | — | $125 – $131 |
| 8 | Victor Valley Global Medical Center Victorville, CA | $612 | $1.8k | $2.1k | 117% | — | $159 – $6k |
| 9 | Piney Woods Healthcare System LP Lufkin, TX | $156 | $192 | $87 | 45% | — | $108 – $312 |
| 10 | The Queens Medical Center Ewa Beach, HI | $127 | $174 | $82 | 47% | — | $127 – $354 |
Ask Claude or any MCP client for HCPCS Q4125 pricing at a specific hospital — see how to connect.