HCPCS A6204 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 • Miscellaneous Dressing and Wound Supplies |
| Complexity Level | Low |
National average reimbursement for HCPCS A6204 by major payers:
$7.11
$4.64
$5.92
$10.26
| 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 A6204 | ||||||
United | A6204 | $4.25 | 1982660569 - TALLAHASSEE NEUROLOGICAL CLINIC | 591286000 - (FL) TALLAHASSEE NEUROLOGICAL CLINIC, P. | FL | Neurological Surgery Physician (207T00000X) |
United | A6204 | $4.34 | 1265460273 - DONNA BROWN | 593502688 - (FL) FLORIDA PODIATRY PA | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | A6204 | $4.34 | 1023076312 - KYLE KINMON | 270492585 - (FL) CERTIFIED FOOT ANKLE SPECIALISTS | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | A6204 | $3.69 | 1891740965 - RIPAL PATEL | 591271306 - (FL) ODRO, FAZEKAS, & WERD, P.A. | FL | Podiatrist (213E00000X) |
United | A6204 | $14.09 | 1992166532 - AZUKA OLELE | 521467441 - JOHNS HOPKINS COMMUNITY PHYSICIANS INC | FL | Podiatrist (213E00000X) |
United | A6204 | $4.34 | 1598285207 - STEPHANIE KANE | 881463522 | FL | Podiatrist (213E00000X) |
United | A6204 | $4.34 | 1477530905 - GEORGE WILLIAMS | 463031935 - (FL) FAMILY FOOT AND ANKLE SOLUTIONS INC | FL | Podiatrist (213E00000X) |
United | A6204 | $3.74 | 1386610327 - JAMES DIVINCENZO | 650079126 - (FL) SAMMY DIVINCENZO PA | FL | Podiatrist (213E00000X) |
United | A6204 | $4.09 | 1548502867 - BAMIDELE OLUPONA | 812378238 - (FL) WELLNESS MEDICAL CENTER LLC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | A6204 | $19.71 | 1013264860 - DUNBAR ALCINDOR | 591867557 - UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS INC | FL | Neurological Surgery Physician (207T00000X) |
United | A6204 | $4.34 | 1407819949 - WARREN WINDRAM | 596012065 - NORTH BROWARD HOSPITAL DISTRICT | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | A6204 | $2.46 | 1952745796 - JAMES SHAW | 452298151 - (TX) SPECIALTY ASSOCIATES OF WEST HOUSTON PLLC | TX | Orthopaedic Trauma Physician (207XX0801X) |
United | A6204 | $4.34 | 1548502867 - BAMIDELE OLUPONA | 261807699 - (FL) HOOVER FAMILY MEDICINE, P.A. | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | A6204 | $4.25 | 1184631053 - PERCY NELSON | 582252849 - (FL) PERCY LEE NELSON DPM PA | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | A6204 | $5.30 | 1881662716 - MICHAEL HOROWITZ | 30587335 - (FL) MEMORIAL NEUROSURGERY GROUP LLC | FL | Neurological Surgery Physician (207T00000X) |
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 A6204 vs. Other Miscellaneous Dressing and Wound Supplies Codes
The HCPCS A6204 code is part of the Medical And Surgical Supplies services used for Miscellaneous Dressing and Wound Supplies. 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 A6204 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 |
|---|---|---|
| A6203-HCPCS | Low | Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
| A6204-HCPCS | Low | Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
| A6205-HCPCS | Low | Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A6204. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6204 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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