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See a sample rate comparisonHCPCS A5503 Fee Schedule
HCPCS A5503 is classified under Medical And Surgical Supplies, in the Diabetic Footwear subgroup.
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
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Diabetic Footwear |
| Complexity Level | Low |
| Medicaid Fee Schedule | $39.13 median of the 8 states in the free preview · View Medicaid rates for A5503 |
National average reimbursement for HCPCS A5503 by major payers:
$38.03
BCBS / Anthem
$23.13
UnitedHealthcare
$30.37
Aetna
$36.72
Cigna
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HCPCS A5503
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$78.17Published rateUnion County Hospital Authority, Union General Hospital
Union County Hospital Authority
$35.52Published rateFloyd Healthcare Management Inc, Atrium Health Floyd Medical Center
Floyd Healthcare Management, Inc.
$21.31Published rateEffingham Hospital, Inc., Effingham Health System
Effingham Hospital Inc
$20.95Published rateHospital Authority Of Jenkins County
$17.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A5503 vs. Other Diabetic Footwear Codes
The table lists codes related to A5503. Select one to see its fee schedule.
| 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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