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See a sample rate comparisonHCPCS A4412 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 pouch, drainable, high output, for use on a barrier with flange (2-piece system), without filter, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4412 |
National average reimbursement for HCPCS A4412 by major payers:
$3.25
$2.01
$2.68
$4.38
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HCPCS A4412
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$6.91Published rateUnion County Hospital Authority, Union General Hospital
Union County Hospital Authority
$3.14Published rateDublin Vamc
$2.16Published rateLower Oconee Community Hospital Inc
$1.75Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$1.21Published rate
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See a sample payer proposalHCPCS A4412 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A4412 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 A4412 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 |
|---|---|---|
| A4411-HCPCS | Low | Ostomy skin barrier, solid 4x4 or equivalent, extended wear, with built-in convexity, each |
| A4412-HCPCS | Low | Ostomy pouch, drainable, high output, for use on a barrier with flange (2-piece system), without filter, each |
| A4413-HCPCS | Low | Ostomy pouch, drainable, high output, for use on a barrier with flange (2-piece system), with filter, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4412 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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