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HCPCS A4209 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Syringe with needle, sterile 5 cc or greater, each
Key FactDetail
Service Type

Medical And Surgical Supplies

Injection and Infusion Supplies

Complexity LevelLow

National average reimbursement for HCPCS A4209 by major payers:

bcbs

$10.81

uhc

$0.26

aetna

$0.36

cigna

$0.83

Preview provider-level rates for...
For billing codeHCPCS A4209
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS A4209

United
A4209$0.261699053702 - ELEANOR MERRILL540620889 - INOVA HEALTH CARE SERVICESVAPhysical Therapist (225100000X)
United
A4209$0.431043954027 - OLIVIA LOY540620889 - INOVA HEALTH CARE SERVICESVANurse Practitioner (363L00000X)
United
A4209$0.261689601320 - BOBBY COCKRAM540620889 - INOVA HEALTH CARE SERVICESVAPhysician Assistant (363A00000X)
United
A4209$0.261932770245 - CECILIA GARCIA540620889 - INOVA HEALTH CARE SERVICESVAFamily Nurse Practitioner (363LF0000X)
United
A4209$0.261164447264 - LAURA EVANS540620889 - INOVA HEALTH CARE SERVICESMAFamily Nurse Practitioner (363LF0000X)
United
A4209$0.261548370612 - RAYMOND WADLOW540620889 - INOVA HEALTH CARE SERVICESVAHematology & Oncology Physician (207RH0003X)
United
A4209$0.261144840505 - JENNIFER ZAPTIN540620889 - INOVA HEALTH CARE SERVICESVARegistered Nurse (163W00000X)
United
A4209$0.261851520969 - ANSON BROWN540620889 - INOVA HEALTH CARE SERVICESVAPhysician Assistant (363A00000X)
United
A4209$0.261851694202 - TRACY WEBB540620889 - INOVA HEALTH CARE SERVICESVAPhysician Assistant (363A00000X)
United
A4209$0.261376701946 - JEANNY ARAGON-CHING540620889 - INOVA HEALTH CARE SERVICESVAMedical Oncology Physician (207RX0202X)
United
A4209$0.261881046225 - FIDELIS ENYINNAYA540620889 - INOVA HEALTH CARE SERVICESVAEmergency Medicine Physician (207P00000X)
United
A4209$0.261568674067 - PETER LEARN540620889 - INOVA HEALTH CARE SERVICESVASurgery Physician (208600000X)
United
A4209$0.261629391701 - ERIN GOOCH540620889 - INOVA HEALTH CARE SERVICESILPhysical Therapist (225100000X)
United
A4209$0.261962868315 - ALYSIA JORDAN540620889 - INOVA HEALTH CARE SERVICESVAPhysical Therapist (225100000X)
United
A4209$0.261699768952 - RACHEL HINERMAN540620889 - INOVA HEALTH CARE SERVICESVACritical Care Medicine (Internal Medicine) Physician (207RC0200X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS A4209 vs. Other Injection and Infusion Supplies Codes

The HCPCS A4209 code is part of the Medical And Surgical Supplies services used for Injection and Infusion Supplies. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS A4209 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
A4208-HCPCSLowSyringe with needle, sterile 3 cc, each
A4209-HCPCSLowSyringe with needle, sterile 5 cc or greater, each
A4210-HCPCSModerateNeedle-free injection device, each

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4209. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A4209 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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