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
57877-0005-13 - skin substitute 2.25 cm2 Misc
Low
$108
Average
$1.1k
Median
$509
High
$5.4k
Filter by billing methodology
Reflects a negotiated per diem rate paid per day of care.
Showing only prices reported under the per diem methodology. Choose another in the filter above to change the chart. 35 hospitals; the 90th percentile is 32.6× 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 | Porter Hospital LLC Valparaiso, IN | $132 | $132 | — | — | — | $117 – $537 |
| 2 | Northwest Sahurita Hospital LLC Tucson, AZ | $132 | $132 | $1 | 1% | — | $131 – $252 |
| 3 | Northwest Sahurita Hospital LLC Sahuarita, AZ | $132 | $132 | $1 | 1% | — | $131 – $252 |
| 4 | Cocke County HMA, LLC Newport, TN | $121 | $121 | $1 | 1% | — | $119 – $409 |
| 5 | Oro Valley Hospital LLC Tucson, AZ | $132 | $132 | $1 | 1% | — | $131 – $305 |
| 6 | Campbell County HMA, LLC LaFollette, TN | $121 | $121 | $2 | 1% | — | $119 – $18.9k |
| 7 | Northwest Hospital LLC Tucson, AZ | $132 | $132 | $1 | 1% | — | $131 – $305 |
| 8 | Jefferson County HMA LLC Jefferson City, TN | $113 | $113 | — | — | — | $111 – $262 |
| 9 | Metro Knoxville HMA LLC Knoxville, TN | $113 | $113 | — | — | — | $111 – $260 |
| 10 | Metro Knoxville HMA LLC Powell, TN | $112 | $112 | $1 | 1% | — | $111 – $209 |
Ask Claude or any MCP client for HCPCS Q4159 pricing at a specific hospital — see how to connect.