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See a sample rate comparisonHCPCS A4561 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.
Pessary, reusable, rubber, any type
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Various Medical Supplies Including Tapes and Surgical Dressings |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4561 |
National average reimbursement for HCPCS A4561 by major payers:
$23.76
$15.44
$20.60
$22.62
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HCPCS A4561
5 of 25 sample ratesHigher to lower in this preview
Rabia Siddik-Ahmad
Sutter Bay Medical Foundation
$70.69Published rateSandra Birnbaum
St Lukes Physician Group Inc
$24.20Published rateChristopher Raio
Mercy Medical Center
$20.86Published rateMichael Shuler
Athens Orthopedic Clinic, PA
$14.35Published rateChristopher Raio
St Francis Hospital
$8.34Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A4561 vs. Other Various Medical Supplies Including Tapes and Surgical Dressings Codes
The HCPCS A4561 code is part of the Medical And Surgical Supplies services used for Various Medical Supplies Including Tapes and Surgical Dressings. 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 A4561 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 |
|---|---|---|
| A4560-HCPCS | Low | Neuromuscular electrical stimulator (nmes), disposable, replacement only |
| A4561-HCPCS | Low | Pessary, reusable, rubber, any type |
| A4562-HCPCS | Low | Pessary, reusable, non rubber, any type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4561 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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