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See a sample rate comparisonHCPCS A4312 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.
Insertion tray without drainage bag with indwelling catheter, Foley type, 2-way, all silicone
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Incontinence Devices and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4312 |
National average reimbursement for HCPCS A4312 by major payers:
$20.25
$12.83
$16.46
$29.57
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HCPCS A4312
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$37.42Published rateTift Regional Health System, Inc., Southwell Medical
Tift Regional Health System Inc
$14.48Published rateWillamette Community Health Solutions, Cascade Health Solutions
$10.68Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$9.96Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$7.13Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4312 vs. Other Incontinence Devices and Supplies Codes
The HCPCS A4312 code is part of the Medical And Surgical Supplies services used for Incontinence Devices and 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 A4312 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 |
|---|---|---|
| A4311-HCPCS | Low | Insertion tray without drainage bag with indwelling catheter, Foley type, 2-way latex with coating (Teflon, silicone, silicone elastomer or hydrophilic, etc.) |
| A4312-HCPCS | Low | Insertion tray without drainage bag with indwelling catheter, Foley type, 2-way, all silicone |
| A4313-HCPCS | Low | Insertion tray without drainage bag with indwelling catheter, Foley type, 3-way, for continuous irrigation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4312. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4312 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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