Search by Drug Name, NDC or Jcode

    Internal Navigation

    HCPCS Details

    HCPC Q4124
    Short Description Oasis tri-layer wound matrix
    Long Description Oasis ultra tri-layer wound matrix, 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 2012-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    08213000009 Q4124 Oasis tri-layer wound matrix OASIS ULTRA TRI-LAYER MATRIX COOK BIOTECH (SMITH & NEPHEW, INC.) 1 SQ CM 1 5 70 70
    08213000011 Q4124 Oasis tri-layer wound matrix OASIS ULTRA TRI-LAYER MATRIX COOK BIOTECH (SMITH & NEPHEW, INC.) 1 SQ CM 1 5 140 140
    08213000013 Q4124 Oasis tri-layer wound matrix OASIS Ultra Tri-Layer Matrix COOK BIOTECH (SMITH & NEPHEW, INC.) 1 SQ CM 35 5 35 35
    08213000016 Q4124 Oasis tri-layer wound matrix OASIS ULTRA TRI-LAYER MATRIX COOK BIOTECH (SMITH & NEPHEW, INC.) 1 SQ CM 10.5 5 10.5 52.5
    08213000018 Q4124 Oasis tri-layer wound matrix OASIS ULTRA TRI-LAYER MATRIX COOK BIOTECH (SMITH & NEPHEW, INC.) 1 SQ CM 21 5 21 105
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 1 SQ CM
    HCPCS/CPT Billing Units 1
    Total doses ordered
    Billing Units 1