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 A5055 Fee Schedule
HCPCS A5055 is classified under Medical And Surgical Supplies, in the Ostomy Pouches and Supplies subgroup.
Stoma cap
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Ostomy Pouches and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | $1.72 median of the 8 states in the free preview · View Medicaid rates for A5055 |
National average reimbursement for HCPCS A5055 by major payers:
$1.64
BCBS / Anthem
$1.05
UnitedHealthcare
$1.36
Aetna
$2.38
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS A5055.
HCPCS A5055
5 of 25 sample ratesHigher to lower in this preview
Emory Healthcare
Emory University
$3.39Published rateJacob Holloway
$1.00Published rateEmanuel County Hospital Authority, Emanuel Medical Center
$0.94Published rateJenkins County Hospital LLC, Optim Medical Center - Jenkins
$0.93Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$0.63Published 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 A5055 vs. Other Ostomy Pouches and Supplies Codes
The table lists codes related to A5055. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A5054-HCPCS | Low | Ostomy pouch, closed; for use on barrier with flange (2-piece), each |
| A5055-HCPCS | Low | Stoma cap |
| A5056-HCPCS | Low | Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1-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 A5055. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5055 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 A5055) and we'll show you how you compare in 15 minutes or less.