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See a sample rate comparisonHCPCS A5053 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, closed; for use on faceplate, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A5053 |
National average reimbursement for HCPCS A5053 by major payers:
$1.97
$1.24
$1.58
$2.82
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HCPCS A5053
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$3.81Published rateMarissa Liveris
Allergy & Asthma Of Dupage, S.C.
$2.87Published rateCatherine Lee
Columbus Arthritis Center
$1.10Published rateHospital Authority Of Liberty County, Liberty Regional Medical Center
$0.99Published rateChristopher Raio
St Francis Hospital
$0.69Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A5053 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A5053 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 A5053 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 |
|---|---|---|
| A5052-HCPCS | Low | Ostomy pouch, closed; without barrier attached (1-piece), each |
| A5053-HCPCS | Low | Ostomy pouch, closed; for use on faceplate, each |
| A5054-HCPCS | Low | Ostomy pouch, closed; for use on barrier with flange (2-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 A5053. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5053 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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