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See a sample rate comparisonHCPCS A5512 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, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees Fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Diabetic Footwear |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A5512 |
National average reimbursement for HCPCS A5512 by major payers:
$29.12
$19.83
$24.14
$29.83
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HCPCS A5512
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$67.41Published rateThe Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$41.75Published rateFloyd Healthcare Management Inc, Atrium Health Floyd Medical Center
Floyd Healthcare Management, Inc.
$18.07Published rateChi Memorial Hospital
Chi Memorial Hospital - Georgia
$16.27Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$12.05Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A5512 vs. Other Diabetic Footwear Codes
The HCPCS A5512 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 A5512 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 |
|---|---|---|
| A5510-HCPCS | Low | For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe |
| A5512-HCPCS | Low | For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees Fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
| A5513-HCPCS | Low | For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A5512. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A5512 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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