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See a sample rate comparisonHCPCS A4423 Fee Schedule
HCPCS A4423 is classified under Medical And Surgical Supplies, in the Ostomy Pouches and Supplies subgroup.
Ostomy pouch, closed; for use on barrier with locking flange, with filter (2-piece), each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | $2.28 median of the 7 states in the free preview · View Medicaid rates for A4423 |
National average reimbursement for HCPCS A4423 by major payers:
$2.18
BCBS / Anthem
$1.38
UnitedHealthcare
$1.76
Aetna
$2.21
Cigna
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HCPCS A4423
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$4.75Published ratePhoebe Putney Memorial Hospital Inc, Phoebe Putney Memorial Hosptial
Phoebe Physician Group Inc
$2.18Published rateUpson County Hospital Inc, Upson Regional Medical Center
Upson County Hospital Inc
$1.29Published rateDevon Daney
Aztec Urgent Care LLC
$1.01Published rateChristopher Raio
St Joseph Hospital
$0.78Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4423 vs. Other Ostomy Pouches and Supplies Codes
The table lists codes related to A4423. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A4422-HCPCS | Low | Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each |
| A4423-HCPCS | Low | Ostomy pouch, closed; for use on barrier with locking flange, with filter (2-piece), each |
| A4424-HCPCS | Low | Ostomy pouch, drainable, with barrier attached, with filter (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 A4423. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4423 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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