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See a sample rate comparisonHCPCS A5054 Fee Schedule
HCPCS A5054 is classified under Medical And Surgical Supplies, in the Ostomy Pouches and Supplies subgroup.
Ostomy pouch, closed; for use on barrier with flange (2-piece), each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | $2.10 median of the 8 states in the free preview · View Medicaid rates for A5054 |
National average reimbursement for HCPCS A5054 by major payers:
$2.11
BCBS / Anthem
$1.33
UnitedHealthcare
$1.70
Aetna
$2.79
Cigna
Compare published rates across providers.
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HCPCS A5054
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$4.60Published rateEmory Healthcare
Emory University
$3.59Published rateFloyd Healthcare Management Inc, Atrium Health Floyd Medical Center
Floyd Healthcare Management, Inc.
$1.25Published rateHouston Hospitals Inc, Houston Medical Center
Houston Hospitals Inc
$1.15Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.80Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A5054 vs. Other Ostomy Pouches and Supplies Codes
The table lists codes related to A5054. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| A5055-HCPCS | Low | Stoma cap |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A5054. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5054 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
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