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See a sample rate comparisonHCPCS A4363 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 clamp, any type, replacement only, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4363 |
National average reimbursement for HCPCS A4363 by major payers:
$2.74
$1.69
$2.19
$3.95
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HCPCS A4363
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$6.05Published rateChu Chen
$3.23Published rateGrady Memorial Hospital Corporation, Grady Health Systems
Grady Memorial Hospital Corporation
$1.39Published ratePaulding Medical Center, Inc., Wellstar Paulding Hospital
Paulding Medical Center Inc
$1.30Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$1.30Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4363 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A4363 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 A4363 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 |
|---|---|---|
| A4362-HCPCS | Low | Skin barrier; solid, 4 x 4 or equivalent; each |
| A4363-HCPCS | Low | Ostomy clamp, any type, replacement only, each |
| A4364-HCPCS | Low | Adhesive, liquid or equal, any type, per oz |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4363. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4363 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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