Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS A4263 Fee Schedule
Last Verified: September 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.
Permanent, long term, non-dissolvable lacrimal duct implant, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Other Supplies Including Diabetes Supplies and Contraceptives |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4263 |
National average reimbursement for HCPCS A4263 by major payers:
$19.60
$21.03
$20.91
$28.06
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A4263.
HCPCS A4263
5 of 25 sample ratesHigher to lower in this preview
Kelly Ridges
Allergy & Asthma Of Dupage, S.C.
$42.90Published rateSmith Of Georgia, Smith Northview Hospitalists
Smith Of Georgia
$26.65Published rateHospital Authority Of Jenkins County
Hospital Authority Of Jenkins County Dba Jenkins County Medical Center
$23.87Published rateUjuka Iloabuchi
$17.29Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$10.27Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS A4263 vs. Other Other Supplies Including Diabetes Supplies and Contraceptives Codes
The HCPCS A4263 code is part of the Medical And Surgical Supplies services used for Other Supplies Including Diabetes Supplies and Contraceptives. 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 A4263 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.
| Code | Complexity | Description |
|---|---|---|
| A4262-HCPCS | Low | Temporary, absorbable lacrimal duct implant, each |
| A4263-HCPCS | Low | Permanent, long term, non-dissolvable lacrimal duct implant, each |
| A4264-HCPCS | Moderate | Permanent implantable contraceptive intratubal occlusion device(s) and delivery system |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4263. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4263 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS A4263) and we'll show you how you compare in 15 minutes or less.