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See a sample rate comparisonHCPCS A5073 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, urinary; 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 | View Medicaid rates for A5073 |
National average reimbursement for HCPCS A5073 by major payers:
$3.70
$2.32
$2.99
$5.16
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HCPCS A5073
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$8.12Published rateEmory University Hospital
Emory University
$7.50Published rateAtlanta Vamc
$2.53Published rateJasper Health Services, Inc., Jasper Memorial Hospital
Jasper Health Services Inc
$2.06Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$1.41Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A5073 vs. Other Ostomy Pouches and Supplies Codes
The HCPCS A5073 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 A5073 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 |
|---|---|---|
| A5072-HCPCS | Low | Ostomy pouch, urinary; without barrier attached (1-piece), each |
| A5073-HCPCS | Low | Ostomy pouch, urinary; for use on barrier with flange (2-piece), each |
| A5081-HCPCS | Low | Stoma plug or seal, 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 A5073. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5073 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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