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See a sample rate comparisonHCPCS A4361 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.
Ostomy faceplate, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4361 |
National average reimbursement for HCPCS A4361 by major payers:
$21.31
$13.13
$17.09
$30.33
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HCPCS A4361
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$45.54Published rateUnion County Hospital Authority, Union General Hospital
Union County Hospital Authority
$18.73Published rateWillamette Community Health Solutions, Cascade Health Solutions
$10.88Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$10.47Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$8.19Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4361 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A4361 code is part of the Medical And Surgical Supplies services used for Ostomy Pouches 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 A4361 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 |
|---|---|---|
| A4360-HCPCS | Low | Disposable external urethral clamp or compression device, with pad and/or pouch, each |
| A4361-HCPCS | Low | Ostomy faceplate, each |
| A4362-HCPCS | Low | Skin barrier; solid, 4 x 4 or equivalent; each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4361. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4361 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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