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See a sample rate comparisonHCPCS A4351 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.
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Incontinence Devices and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4351 |
National average reimbursement for HCPCS A4351 by major payers:
$1.91
$1.30
$1.63
$3.14
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HCPCS A4351
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$4.64Published rateNorthside Hospital, Inc., Northside Hospital Forsyth
Northside Hospital Inc
$1.72Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$1.21Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$1.16Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.81Published rate
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See a sample payer proposalHCPCS A4351 vs. Other Incontinence Devices and Supplies Codes
The HCPCS A4351 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 A4351 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 |
|---|---|---|
| A4349-HCPCS | Low | Male external catheter, with or without adhesive, disposable, each |
| A4351-HCPCS | Low | Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
| A4352-HCPCS | Low | Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4351. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4351 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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