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See a sample rate comparisonHCPCS A4421 Fee Schedule
HCPCS A4421 is classified under Medical And Surgical Supplies, in the Ostomy Pouches and Supplies subgroup.
Ostomy supply; miscellaneous
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | $4.68 median of the 5 states in the free preview · View Medicaid rates for A4421 |
National average reimbursement for HCPCS A4421 by major payers:
$313.18
BCBS / Anthem
$80.69
UnitedHealthcare
$4.98
Aetna
$72.90
Cigna
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HCPCS A4421
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See a sample payer proposalHCPCS A4421 vs. Other Ostomy Pouches and Supplies Codes
The table lists codes related to A4421. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A4420-HCPCS | Low | Ostomy pouch, closed; for use on barrier with locking flange (2-piece), each |
| A4421-HCPCS | Moderate | Ostomy supply; miscellaneous |
| A4422-HCPCS | Low | Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4421. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4421 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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