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HCPCS A4396 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 belt with peristomal hernia support
Key FactDetail
Service Type

Medical And Surgical Supplies

Ostomy Pouches and Supplies

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for A4396

National average reimbursement for HCPCS A4396 by major payers:

bcbs

$47.05

uhc

$29.89

aetna

$39.10

cigna

$66.41

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS A4396.

HCPCS A4396
5 of 25 sample ratesHigher to lower in this preview
  1. Chu Chen

    Merrimack Valley Pediatric Associates, Inc.

    MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572

    $103.47Published rate
  2. Piedmont Newton Hospital, Inc., Newton Medical Center

    Piedmont Newton Hospital Inc

    GAGeneral Acute Care HospitalNPI 1760498588Tax ID 81-4475074

    $42.56Published rate
  3. Floyd Healthcare Management Inc, Atrium Health Floyd Medical Center

    Floyd Healthcare Management, Inc.

    GAGeneral Acute Care HospitalNPI 1154377166Tax ID 58-1973570

    $28.21Published rate
  4. Jasper Health Services, Inc., Jasper Memorial Hospital

    Jasper Health Services Inc

    GACritical Access HospitalNPI 1225031750Tax ID 58-2510435

    $26.30Published rate
  5. Good Samaritan Hospital, Inc., St. Mary'S Good Samaritan Hospital

    Good Samaritan Hospital Inc

    GACritical Access HospitalNPI 1346209137Tax ID 26-1720984

    $18.80Published rate

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

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HCPCS A4396 vs. Other Ostomy Pouches and Supplies Codes

The HCPCS A4396 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 A4396 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.

CodeComplexityDescription
A4395-HCPCSLowOstomy deodorant for use in ostomy pouch, solid, per tablet
A4396-HCPCSLowOstomy belt with peristomal hernia support
A4398-HCPCSLowOstomy irrigation supply; bag, each

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4396. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A4396 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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