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See a sample rate comparisonHCPCS A5131 Fee Schedule
HCPCS A5131 is classified under Medical And Surgical Supplies, in the Incontinence Devices and Supplies subgroup.
Appliance cleaner, incontinence and ostomy appliances, per 16 oz.
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Incontinence Devices and Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | $16.76 median of the 7 states in the free preview · View Medicaid rates for A5131 |
National average reimbursement for HCPCS A5131 by major payers:
$16.60
BCBS / Anthem
$11.26
UnitedHealthcare
$14.32
Aetna
$22.41
Cigna
Compare published rates across providers.
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HCPCS A5131
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$40.50Published ratePhoebe Worth Medical Center, Inc, Phoebe Worth Medical Center, Inc
Phoebe Worth Medical Center Inc
$18.64Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$10.59Published ratePalmyra Park Hospital, Inc., Palmyra Medical Centers
$10.31Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$7.07Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A5131 vs. Other Incontinence Devices and Supplies Codes
The table lists codes related to A5131. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A5126-HCPCS | Low | Adhesive or non-adhesive; disk or foam pad |
| A5131-HCPCS | Low | Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
| A5200-HCPCS | Low | Percutaneous catheter/tube anchoring device, adhesive skin attachment |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A5131. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5131 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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