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See a sample rate comparisonHCPCS A4426 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; for use on barrier with locking flange (2-piece system), each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4426 |
National average reimbursement for HCPCS A4426 by major payers:
$3.26
$2.02
$2.62
$3.11
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HCPCS A4426
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$6.97Published rateUnion County Hospital Authority, Union General Hospital
Union County Hospital Authority
$3.17Published rateScottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$1.89Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$1.76Published rateMichael Guillette
Aztec Urgent Care LLC
$1.50Published rate
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See a sample payer proposalHCPCS A4426 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A4426 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 A4426 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 |
|---|---|---|
| A4425-HCPCS | Low | Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2-piece system), each |
| A4426-HCPCS | Low | Ostomy pouch, drainable; for use on barrier with locking flange (2-piece system), each |
| A4427-HCPCS | Low | Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2-piece system), each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4426. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4426 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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