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See a sample rate comparisonHCPCS A5501 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.
For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Diabetic Footwear |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for A5501 |
National average reimbursement for HCPCS A5501 by major payers:
$223.43
$145.77
$174.52
$219.38
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HCPCS A5501
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$487.45Published rateHamilton Medical Center, Inc.
Hamilton Medical Center Inc
$221.57Published rateCharleston Radiologists PA
Charleston Radiologists, P.A.
$150.19Published rateNorthside Hospital, Inc., Northside Hospital Duluth
$120.70Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$90.12Published rate
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See a sample payer proposalHCPCS A5501 vs. Other Diabetic Footwear Codes
The HCPCS A5501 code is part of the Medical And Surgical Supplies services used for Diabetic Footwear. 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 A5501 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 |
|---|---|---|
| A5500-HCPCS | Low | For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi- density insert(s), per shoe |
| A5501-HCPCS | Moderate | For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe |
| A5503-HCPCS | Low | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A5501. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5501 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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