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See a sample rate comparisonHCPCS A4361 is classified under Medical And Surgical Supplies, in the Ostomy Pouches and Supplies subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | $21.945 median of the 8 states in the free preview · View Medicaid rates for A4361 |
National average reimbursement for HCPCS A4361 by major payers:

$21.31
BCBS / Anthem

$13.13
UnitedHealthcare

$17.09
Aetna

$30.33
Cigna
Choose a payer to see a sample of rates for HCPCS A4361.
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
Union County Hospital Authority, Union General Hospital
Union County Hospital Authority
Willamette Community Health Solutions, Cascade Health Solutions
Palmyra Park Hospital, Inc., Palmyra Medical Centers
Borbas Surgical Supply, Inc
Borbas Surgical Supply Inc
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS A4361 vs. Other Ostomy Pouches and Supplies Codes
The table lists codes related to A4361. Select one to see its fee schedule.
| 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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