HCPCS A6530 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 • Compression Garments and Stockings |
| Complexity Level | Low |
National average reimbursement for HCPCS A6530 by major payers:
$33.33
$25.73
$31.27
$28.71
| 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 A6530 | ||||||
United | A6530 | $36.93 | 1811420433 - BRIAN FREEMAN | 812716597 - (NE) EPN OF NEBRASKA LLC | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $22.15 | 1578504528 - MARK SHIRLEY | 420670596 - (IA) SUMNER COMMUNITY CLUB | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $22.15 | 1336150739 - BRENT BUNZ | 201357375 - BRYAN PHYSICIAN NETWORK | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $44.31 | 1659494268 - BENJAMIN FAGO | 470662290 - (NE) NORTH PLATTE NEBRASKA HOSPITAL CORPORATION | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $36.93 | 1578504528 - MARK SHIRLEY | 470765154 - ALEGENT CREIGHTON CLINIC | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $36.93 | 1528053006 - PETER DAHER | 812716597 - (NE) EPN OF NEBRASKA LLC | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $21.04 | 1215985791 - JASON JOHANNING | 470785575 - (NE) UNMC PHYSICIANS | NE | Vascular Surgery Physician (2086S0129X) |
United | A6530 | $31.38 | 1235365875 - JOSEPH MARGHEIM | 470385129 - REGIONAL WEST MEDICAL CENTER | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $53.00 | 1871819896 - OLAMIDE ALABI | 582030692 - EMORY UNIVERSITY | NE | Vascular Surgery Physician (2086S0129X) |
United | A6530 | $22.15 | 1104263078 - YUE GAO | 470687317 - PHYSICIANS CLINIC INC | NE | Vascular Surgery Physician (2086S0129X) |
United | A6530 | $22.15 | 1083725386 - TERRY ROUNSBORG | 352621082 - GRAND ISLAND REGIONAL MEDICAL CENTER | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $22.15 | 1215506548 - JOHN DERR | 470785575 - (NE) UNMC PHYSICIANS | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $36.93 | 1790851962 - DARIUSH GHAFFARI | 420928451 - (IA) FLOYD VALLEY HOSPITAL | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $22.15 | 1407087489 - NEBRASKA ORTHOPAEDIC HOSPITAL LLC | 470845237 - (NE) NEBRASKA ORTHOPAEDIC HOSPITAL, LLC | NE | Emergency Medicine Physician (207P00000X) |
United | A6530 | $22.15 | 1730441932 - ALBERT DUNN | 470376604 - NEBRASKA METHODIST HOSPITAL | NE | Emergency Medicine Physician (207P00000X) |
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 A6530 vs. Other Compression Garments and Stockings Codes
The HCPCS A6530 code is part of the Medical And Surgical Supplies services used for Compression Garments and Stockings. 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 A6530 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 |
|---|---|---|
| A6513-HCPCS | Low | Compression burn mask, face and/or neck, plastic or equal, custom fabricated |
| A6530-HCPCS | Low | Gradient compression stocking, below knee, 18-30 mmHg, each |
| A6531-HCPCS | Low | Gradient compression stocking, below knee, 30-40 mmHg, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A6530. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6530 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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