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See a sample rate comparisonHCPCS A4459 Fee Schedule
HCPCS A4459 is classified under Medical And Surgical Supplies, in the Various Medical Supplies Including Tapes and Surgical Dressings subgroup.
Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Various Medical Supplies Including Tapes and Surgical Dressings |
| Complexity Level | High |
| Medicaid Fee Schedule | $145.715 median of the 4 states in the free preview · View Medicaid rates for A4459 |
National average reimbursement for HCPCS A4459 by major payers:
$1,613.76
BCBS / Anthem
$114.90
UnitedHealthcare
$364.47
Aetna
$2,252.72
Cigna
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HCPCS A4459
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See a sample payer proposalHCPCS A4459 vs. Other Various Medical Supplies Including Tapes and Surgical Dressings Codes
The table lists codes related to A4459. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A4458-HCPCS | Low | Enema bag with tubing, reusable |
| A4459-HCPCS | High | Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type |
| A4461-HCPCS | Low | Surgical dressing holder, non-reusable, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4459. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4459 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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