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HCPCS A4284 Fee Schedule

Last Verified: November 2025

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.

Breast shield and splash protector for use with breast pump, replacement
Key FactDetail
Service Type

Medical And Surgical Supplies

Other Supplies Including Diabetes Supplies and Contraceptives

Complexity LevelLow

National average reimbursement for HCPCS A4284 by major payers:

bcbs

$6.75

uhc

$9.26

aetna

$8.94

cigna

$8.45

Preview provider-level rates for...
For billing codeHCPCS A4284
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS A4284

United
A4284$33.091073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
A4284$7.571992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS262037695 - GRADY MEMORIAL HOSPITAL CORPORATIONGAGeneral Acute Care Hospital (282N00000X)
United
A4284$33.091073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
A4284$33.091073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
A4284$33.091073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
A4284$10.721760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTERGACritical Access Hospital (282NC0060X)
United
A4284$33.091073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
A4284$7.571255379566 - WILLAMETTE COMMUNITY HEALTH SOLUTIONS, CASCADE HEALTH SOLUTIONS930421470ORDiabetes Educator Registered Nurse (163WD0400X)
United
A4284$7.571093753386 - WILLAMETTE COMMUNITY HEALTH SOLUTIONS, CASCADE HEALTH SOLUTIONS930421470ORCommunity Based Hospice Care Agency (251G00000X)
United
A4284$7.571306136551 - UJUKA ILOABUCHI582483738GAWomen's Hospital (282NW0100X)
United
A4284$14.751992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL263792403 - PHOEBE PHYSICIAN GROUP INCGAGeneral Acute Care Hospital (282N00000X)
United
A4284$7.571801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM581790149 - (GA) TANNER MEDICAL CENTER INCGAGeneral Acute Care Hospital (282N00000X)
United
A4284$18.711861615304 - THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY, APPLING HEALTHCARE SYSTEM586002659 - (GA) APPLING HOSPITALGAGeneral Acute Care Hospital (282N00000X)
United
A4284$10.971902855216 - ATLANTA VAMC582091280GAGeneral Acute Care Hospital (282N00000X)
United
A4284$16.201225281603 - EMORY CRAWFORD LONG HOSPITAL582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
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 A4284 vs. Other Other Supplies Including Diabetes Supplies and Contraceptives Codes

The HCPCS A4284 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 A4284 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
A4283-HCPCSLowCap for breast pump bottle, replacement
A4284-HCPCSLowBreast shield and splash protector for use with breast pump, replacement
A4285-HCPCSLowPolycarbonate bottle for use with breast pump, replacement

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4284. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A4284 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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