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
Xcm biologic tissue matrix, per square centimeter (add-on, list separately in addition to primary procedure)
Low
$28
Average
$971
Median
$74
High
$9.5k
Each hospital's average Medica rate, under the methodology and billing class chosen below.
27 hospitals; the 90th percentile is 62.5× 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.
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28 hospital rates
iThe hospitals that file a Medica rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | BAPTIST HOSPITAL OF MIAMI PLANTATION, FL fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 2 | BETHESDA HOSPITAL BOYNTON BEACH, FL fee schedule · both | 1 | $130 | $130 | — | — | — | $130 – $130 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 4 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $49 | $49 | — | — | — | $49 – $49 |
| 5 | Central Community Hospital Elkader, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 6 | Covenant Medical Center Inc Waterloo, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 7 | DOCTORS HOSPITAL CORAL GABLES, FL fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 8 | FISHERMENS HEALTH, INC MARATHON, FL percent of total billed charges · bothfrom % of charges | 1 | $6.1k | $7.3k | $3.7k | 50% | — | $3.2k – $13.5k |
| 9 | HOMESTEAD HOSPITAL Homestead, FL fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 10 | MARINERS HOSPITAL TAVERNIER, FL percent of total billed charges · bothfrom % of charges | 1 | $6.1k | $7.3k | $3.7k | 50% | — | $3.2k – $13.5k |
| 11 | Mercy Health Services-Iowa Corp. Mason City, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $53 | $53 | — | — | — | $53 – $53 |
| 12 | Mercy Hospital of Franciscan Sisters Inc Oelwein, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $74 | $74 | — | — | — | $74 – $74 |
| 13 | Mercy Medical Center - Dubuque Dubuque, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 14 | Mercy Medical Center - Dyersville Dyersville, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 15 | Mercy Medical Center - New Hampton New Hampton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $87 | $87 | — | — | — | $87 – $87 |
| 16 | Mercy Medical Center - Newton Newton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $69 | $69 | — | — | — | $69 – $69 |
| 17 | Mercy Medical Center-Clinton Inc Clinton, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $68 | $68 | — | — | — | $68 – $68 |
| 18 | Regions Hospital St. Paul, MN facility · percent of total billed charges · bothfrom % of charges | 2 | $9.2k | $9.5k | $4.5k | 47% | — | $2.9k – $17.4k |
| 19 | SOUTH MIAMI HOSPITAL Weston, FL fee schedule · both | 1 | $139 | $139 | — | — | — | $139 – $139 |
| 20 | Sanford Bemidji Medical Center Bemidji, MN percent of total billed charges · inpatientfrom % of charges | 2 | $48 | $49 | $2 | 4% | — | $46 – $51 |
| 21 | Sanford Bemidji Medical Center Bemidji, MN percent of total billed charges · outpatientfrom % of charges | 2 | $48 | $49 | $2 | 4% | — | $46 – $51 |
| 22 | Sanford Fargo Medical Center Fargo, ND percent of total billed charges · outpatientfrom % of charges | 2 | $28 | $28 | $2 | 7% | — | $26 – $31 |
| 23 | Sanford Medical Center Bismarck Bismarck, ND percent of total billed charges · outpatientfrom % of charges | 2 | $38 | $38 | $2 | 5% | — | $36 – $41 |
| 24 | Sanford USD Medical Center Sioux Falls, SD percent of total billed charges · outpatientfrom % of charges | 2 | $54 | $62 | $19 | 31% | — | $36 – $89 |
| 25 | Sartori Memorial Hospital Inc Cedar Falls, IA facility · percent of total billed charges · bothfrom % of charges | 1 | $54 | $54 | — | — | — | $54 – $54 |
← Payers reporting HCPCS Q4142 · Snapshot 20261111T120946Z-9134e7f7