Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS A4625 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.
Tracheostomy care kit for new tracheostomy
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Respiratory Supplies and Equipment |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A4625 |
National average reimbursement for HCPCS A4625 by major payers:
$7.47
$5.00
$6.29
$11.42
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A4625.
HCPCS A4625
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$15.03Published rateHamilton Medical Center, Inc.
Hamilton Medical Center Inc
$8.03Published rateHospital Authority Of Jefferson County And The City Of Louisville, Jefferson Hospital
Hospital Authority Of Jefferson County And The City Of Louisville
$4.88Published rateJasper Health Services, Inc., Jasper Memorial Hospital
Jasper Health Services Inc
$4.50Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$3.09Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS A4625 vs. Other Respiratory Supplies and Equipment Codes
The HCPCS A4625 code is part of the Medical And Surgical Supplies services used for Respiratory Supplies and Equipment. 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 A4625 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 |
|---|---|---|
| A4624-HCPCS | Low | Tracheal suction catheter, any type other than closed system, each |
| A4625-HCPCS | Low | Tracheostomy care kit for new tracheostomy |
| A4626-HCPCS | Low | Tracheostomy cleaning brush, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A4625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A4625 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS A4625) and we'll show you how you compare in 15 minutes or less.