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See a sample rate comparisonHCPCS A4385 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 skin barrier, solid 4x4 or equivalent, extended wear, without built-in convexity, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4385 |
National average reimbursement for HCPCS A4385 by major payers:
$5.98
$3.77
$4.79
$8.30
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HCPCS A4385
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$13.02Published rateAugusta Vamc
$4.07Published rateHospital Authority Of Liberty County, Liberty Regional Medical Center
$3.41Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$3.31Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$2.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4385 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A4385 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 A4385 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 |
|---|---|---|
| A4384-HCPCS | Low | Ostomy faceplate equivalent, silicone ring, each |
| A4385-HCPCS | Low | Ostomy skin barrier, solid 4x4 or equivalent, extended wear, without built-in convexity, each |
| A4387-HCPCS | Low | Ostomy pouch, closed, with barrier attached, with built-in convexity (1-piece), each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4385 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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