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HCPCS Details
| HCPC | Q4107 |
| Short Description | Graftjacket |
| Long Description | Graftjacket, per square centimeter |
| Pricing indicator | 51 |
| Coverage code | C |
| ASC payment group code | |
| BETOS2 code | O1E |
| Action code | N |
| Type of service | 1 |
| Effective date | 2014-01-01 |
| Date Added | 2009-01-01 |