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HCPCS A5122 Fee Schedule

Last Verified: January 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.

Skin barrier; solid, 8 x 8 or equivalent, each
Key FactDetail
Service Type

Medical And Surgical Supplies

Incontinence Devices and Supplies

Complexity LevelLow

National average reimbursement for HCPCS A5122 by major payers:

bcbs

$14.67

uhc

$9.15

aetna

$11.59

cigna

$20.58

Preview provider-level rates for...
For billing codeHCPCS A5122
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS A5122

United
A5122$5.961346209137 - GOOD SAMARITAN HOSPITAL, INC., ST. MARY'S GOOD SAMARITAN HOSPITAL261720984 - (GA) GOOD SAMARITAN HOSPITAL INCGACritical Access Hospital (282NC0060X)
United
A5122$8.351194779702 - JOHN D. ARCHBOLD MEMORIAL HOSPITAL, INC.580566121 - JOHN D ARCHBOLD MEMORIAL HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
A5122$8.571811962756 - EFFINGHAM HOSPITAL, INC., EFFINGHAM HEALTH SYSTEM474393589 - (GA) EFFINGHAM HOSPITAL INCGACritical Access Hospital (282NC0060X)
United
A5122$12.141770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIAGACritical Access Hospital (282NC0060X)
United
A5122$12.431073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
A5122$8.941659376630 - UPSON COUNTY HOSPITAL INC, UPSON REGIONAL MEDICAL CENTER581734026 - (GA) UPSON COUNTY HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
A5122$8.571245201094 - SCREVEN COUNTY HOSPITAL273100946GACritical Access Hospital (282NC0060X)
United
A5122$13.511689063554 - ATL COLORECTAL SURGERY205040872 - (GA) ATL COLORECTAL SURGERYGAGeneral Acute Care Hospital (282N00000X)
United
A5122$8.941992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS262037695 - GRADY MEMORIAL HOSPITAL CORPORATIONGAGeneral Acute Care Hospital (282N00000X)
United
A5122$7.031174512115 - MICHAEL GUILLETTE271495988 - (NM) AZTEC URGENT CARE LLCCOPhysician Assistant (363A00000X)
United
A5122$30.291598964082 - EMORY HEALTHCARE582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
A5122$15.101639157431 - PHOEBE WORTH MEDICAL CENTER, INC, PHOEBE WORTH MEDICAL CENTER, INC383647394 - (GA) PHOEBE WORTH MEDICAL CENTER INCGACritical Access Hospital (282NC0060X)
United
A5122$11.471063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
A5122$10.111043265564 - MONROE HMA, LLC, CLEARVIEW REGIONAL MEDICAL CENTER200141568 - (GA) MONROE HMA LLCGAGeneral Acute Care Hospital (282N00000X)
United
A5122$8.351982658944 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS721553462GAGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS A5122 vs. Other Incontinence Devices and Supplies Codes

The HCPCS A5122 code is part of the Medical And Surgical Supplies services used for Incontinence Devices 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 A5122 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.

CodeComplexityDescription
A5121-HCPCSLowSkin barrier; solid, 6 x 6 or equivalent, each
A5122-HCPCSLowSkin barrier; solid, 8 x 8 or equivalent, each
A5126-HCPCSLowAdhesive or non-adhesive; disk or foam pad

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A5122. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A5122 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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