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Surgraft XT per square centimeter

SurGraft XT® is a dual layer amnion derived allograft

INTENDED USES: Intended for the treatment of non-healing wounds and burn injuries. SurGraft is directed for use in patients with acute or chronic wounds, including but not limited to, chronic, non-infected, diabetic foot ulcers, chronic, non-infected, partial or full-thickness diabetic foot skin ulcers (due to venous insufficiency), pressure ulcer, surgical wounds and burns which have not adequately responded to conventional therapy.

CLAIMED BENEFITS: The membrane sheet provides a protective covering that may aid in wound management; The amniotic membrane has unique non-immunological properties; The extracellular matrix acts as a scaffolding and may potentiate the migration and adhesion of resident cells; The membrane is a natural source of cytokines and growth factors. SurGraft is minimally manipulated Human Cell Tissue Product (HCT/P) intended for homologous use.

OPTIONS: Per Square Centimeter

Product Information

The addition of Skin Substitutes or Cellular or Tissue Based Products (CTPs) to certain wounds may afford a healing advantage over dressings and conservative treatments when these options appear insufficient to affect complete healing, after at least a 30 day period of comprehensive conservative therapy. There are currently a wide variety of bioengineered products available for soft tissue coverage to affect closure. • Human skin allografts are derived from donated human skin (cadavers) • Allogeneic matrices are derived from human tissue (fibroblasts or membrane) • Composite matrices are derived from human keratinocytes, fibroblasts and xenogeneic collagen • Acellular matrices are derived from xenogeneic collagen or tissue

Pricing and Suppliers

Is it covered by Medicare Part B?

Medicare covers the application of Cellular and Tissue Based Products (CTPs) for chronic Wounds, which are defined as wounds that do not respond to standard wound treatment for at least a 30 day period during organized comprehensive conservative therapy. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.

How can I purchase this product?

For Medicare to cover this product, it needs to be ordered and applied by your clinician. A patient cannot purchase it directly from a Durable Medical Equipment (DME) store and receive reimbursement for it.

The table below shows highest and lowest Medicare pricing across the country
DescriptionMedicare DME co-payment Min / Max
  $0.00 / $0.00
Estimated out-of-pocket cost:

If your insurance does not cover this product, you can purchase it directly from any store. A list of online stores and prices is provided below for your convenience. For updated prices, find it on the internet at https://woundreference.com/app/product?id=3238

Other Stores

* Indicates whether store accepts Medicare or commercial insurance, but may not apply to this specific product. See coding, coverage and reimubursement for more information.
The information on this handout is for your convenience and educational purposes only. All product claims and specifications are those of the product suppliers. It does not constitute medical advice or a guarantee for reimbursement. Prices may have changed and suppliers may not have product in stock. Please confirm accuracy and appropriateness of information with insurance carrier and product supplier. Clinician and WoundReference assume no liability for inaccuracies or misstatements about products and insurance coverage.