HCPCS A5503 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medical And Surgical Supplies • Diabetic Footwear |
| Complexity Level | Low |
National average reimbursement for HCPCS A5503 by major payers:
$38.03
$23.13
$30.37
$36.72
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS A5503 | ||||||
United | A5503 | $26.39 | 1861615304 - THE BAXLEY AND APPLING COUNTY HOSPITAL AUTHORITY, APPLING HEALTHCARE SYSTEM | 586002659 - (GA) APPLING HOSPITAL | GA | General Acute Care Hospital (282N00000X) |
United | A5503 | $17.15 | 1457329435 - PAULDING MEDICAL CENTER, INC., WELLSTAR PAULDING HOSPITAL | 582095884 - (GA) PAULDING MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | A5503 | $20.12 | 1255891958 - PIEDMONT NEWTON EKG BILLING LLC | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A5503 | $27.14 | 1902855216 - ATLANTA VAMC | 582091280 | GA | General Acute Care Hospital (282N00000X) |
United | A5503 | $21.31 | 1922178789 - SCOTTISH RITE CHILDRENS MEDICAL CTR, CHILDREN'S HEALTHCARE OF ATLANTA AT SCOTTISH RITE | 580572465 - CHILDRENS HEALTHCARE OF ATLANTA INC | GA | Children's Hospital (282NC2000X) |
United | A5503 | $26.39 | 1508361841 - CHRISTOPHER CHAMBERS | 10594994 - COOPERATIVE HEALTHCARE SERVICES INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | A5503 | $20.37 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 814817422 | GA | Rural Acute Care Hospital (282NR1301X) |
United | A5503 | $17.15 | 1326191180 - PROFESSIONAL RESOURCES MANAGEMENT OF RABUN, LLC, MOUNTAIN LAKES MEDICAL CENTER | 202012765 | GA | Critical Access Hospital (282NC0060X) |
United | A5503 | $33.25 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 581928247 - (GA) PHOEBE PUTNEY MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A5503 | $26.71 | 1770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL | 586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIA | GA | Critical Access Hospital (282NC0060X) |
United | A5503 | $20.37 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 814817422 | GA | Rural Acute Care Hospital (282NR1301X) |
United | A5503 | $19.19 | 1255379566 - WILLAMETTE COMMUNITY HEALTH SOLUTIONS, CASCADE HEALTH SOLUTIONS | 930421470 | OR | Diabetes Educator Registered Nurse (163WD0400X) |
United | A5503 | $49.02 | 1306136551 - UJUKA ILOABUCHI | 474870066 - (GA) GWINNETT OBGYN ASSOCIATES OF GEORGIA LLC | GA | Women's Hospital (282NW0100X) |
United | A5503 | $20.12 | 1760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER | 582155150 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A5503 | $17.15 | 1861478851 - CLINCH COUNTY HOSPITAL AUTHORITY | 586011853 - (GA) CLINCH COUNTY HOSPITAL AUTHORITY | GA | Critical Access Hospital (282NC0060X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS A5503 vs. Other Diabetic Footwear Codes
The HCPCS A5503 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 A5503 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 |
|---|---|---|
| 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 |
| A5504-HCPCS | Low | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), 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 A5503. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5503 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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