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HCPCS A4389 Fee Schedule

HCPCS A4389 is classified under Medical And Surgical Supplies, in the Ostomy Pouches and Supplies subgroup.

Ostomy pouch, drainable, with barrier attached, with built-in convexity (1-piece), each
Key FactDetail
Service Type

Medical And Surgical Supplies

Ostomy Pouches and Supplies

Complexity LevelLow
Medicaid Fee Schedule$7.525 median of the 8 states in the free preview · View Medicaid rates for A4389

National average reimbursement for HCPCS A4389 by major payers:

BCBS / Anthem logo

$7.29

BCBS / Anthem

UnitedHealthcare logo

$4.60

UnitedHealthcare

Aetna logo

$5.93

Aetna

Cigna logo

$10.24

Cigna

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS A4389.

HCPCS A4389
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $15.88Published rate
  2. The Baxley And Appling County Hospital Authority, Appling Healthcare System

    Appling Hospital

    GAGeneral Acute Care HospitalNPI 1861615304Tax ID 58-6002659

    $6.21Published rate
  3. Upson County Hospital Inc, Upson Regional Medical Center

    Upson County Hospital Inc

    GAGeneral Acute Care HospitalNPI 1659376630Tax ID 58-1734026

    $4.32Published rate
  4. Palmyra Park Hospital, Inc., Palmyra Medical Centers

    GAGeneral Acute Care HospitalNPI 1073567038Tax ID 72-1553462

    $4.03Published rate
  5. Wildwood Sanitarium, Incorporated, Wildwood Lifestyle Center And Hospital

    Wildwood Sanitarium Incorporated

    GAGeneral Acute Care HospitalNPI 1235153883Tax ID 58-6039864

    $2.89Published rate

National sample. Rates vary by location, specialty, and contract.

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Payer Contract Negotiation

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HCPCS A4389 vs. Other Ostomy Pouches and Supplies Codes

The table lists codes related to A4389. Select one to see its fee schedule.

CodeComplexityDescription
A4388-HCPCSLowOstomy pouch, drainable, with extended wear barrier attached, (1-piece), each
A4389-HCPCSLowOstomy pouch, drainable, with barrier attached, with built-in convexity (1-piece), each
A4390-HCPCSLowOstomy pouch, drainable, with extended wear 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 A4389. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A4389 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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