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HCPCS A4284 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.

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
Medicaid Fee ScheduleView Medicaid rates for A4284

National average reimbursement for HCPCS A4284 by major payers:

bcbs

$6.75

uhc

$9.26

aetna

$8.94

cigna

$8.45

Compare published rates across providers.

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HCPCS A4284
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $33.09Published rate
  2. Emory Healthcare

    Emory University

    GAGeneral Acute Care HospitalNPI 1598964082Tax ID 58-2030692

    $16.20Published rate
  3. Christopher Raio

    St Joseph Hospital

    NYEmergency Medicine PhysicianNPI 1255478004Tax ID 11-3438973

    $9.96Published rate
  4. Effingham Hospital, Inc., Effingham Health System

    Effingham Hospital Inc

    GACritical Access HospitalNPI 1811962756Tax ID 47-4393589

    $7.53Published rate
  5. Wildwood Sanitarium Incorporated, Wildwood Medical Clinic

    Wildwood Sanitarium Incorporated

    GAGeneral Acute Care HospitalNPI 1902957541Tax ID 58-6039864

    $4.48Published rate

National sample. Rates vary by location, specialty, and contract.

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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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