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HCPCS A7004 Fee Schedule

Last Verified: January 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.

Small volume nonfiltered pneumatic nebulizer, disposable
Key FactDetail
Service Type

Medical And Surgical Supplies

Breathing Aids

Complexity LevelLow

National average reimbursement for HCPCS A7004 by major payers:

bcbs

$1.35

uhc

$1.10

aetna

$1.21

cigna

$2.00

Preview provider-level rates for...
For billing codeHCPCS A7004
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS A7004

United
A7004$1.111689744450 - ARTHUR M. BLANK HOSPITAL, INC., ARTHUR M. BLANK HOSPITAL582147112 - (GA) CHILDRENS HEALTHCARE OF ATLANTA INCGAChildren's Hospital (282NC2000X)
United
A7004$1.611063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
A7004$2.751992799050 - GRADY MEMORIAL HOSPITAL CORPORATION, GRADY HEALTH SYSTEMS581537752 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
United
A7004$1.441902855216 - ATLANTA VAMC582091280GAGeneral Acute Care Hospital (282N00000X)
United
A7004$0.811417157405 - EMORY HEALTHCARE901116753GAGeneral Acute Care Hospital (282N00000X)
United
A7004$1.001588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLCNYMulti-Specialty Group (193200000X)
United
A7004$0.821497756019 - MERIWETHER COUNTY HOSPITAL AUTHORITY, WARM SPRINGS MEDICAL CENTER870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTERGACritical Access Hospital (282NC0060X)
United
A7004$0.821740272095 - DODGE COUNTY HOSPITAL AUTHORITY, DODGE COUNTY HOSPITAL580625140 - (GA) DODGE COUNTY HOSPITAL AUTHORITYGARural Acute Care Hospital (282NR1301X)
United
A7004$0.811548859895 - ALICIA ENCINAS300394179 - (AZ) MIGUEL A ARENAS MD PCCAFamily Nurse Practitioner (363LF0000X)
United
A7004$0.821821017831 - BACON COUNTY HEALTH SERVICES, INC, BACON COUNTY RURAL HEALTH CLINIC582224545 - (GA) BACON COUNTY HEALTH SERVICES INCGARural Acute Care Hospital (282NR1301X)
United
A7004$0.991306890942 - BROOKS COUNTY HOSPITAL586002830GACritical Access Hospital (282NC0060X)
United
A7004$0.821497756019 - MERIWETHER COUNTY HOSPITAL AUTHORITY, WARM SPRINGS MEDICAL CENTER870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTERGACritical Access Hospital (282NC0060X)
United
A7004$1.001790942381 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM MEDICAL CENTER - TATTNALL300466706GACritical Access Hospital (282NC0060X)
United
A7004$1.001790942381 - TATTNALL HOSPITAL COMPANY, LLC, OPTIM MEDICAL CENTER - TATTNALL300466706GACritical Access Hospital (282NC0060X)
United
A7004$3.041073502985 - CHU CHEN42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.MAPediatrics Physician (208000000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS A7004 vs. Other Breathing Aids Codes

The HCPCS A7004 code is part of the Medical And Surgical Supplies services used for Breathing Aids. 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 A7004 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.

CodeComplexityDescription
A7003-HCPCSLowAdministration set, with small volume nonfiltered pneumatic nebulizer, disposable
A7004-HCPCSLowSmall volume nonfiltered pneumatic nebulizer, disposable
A7005-HCPCSLowAdministration set, with small volume nonfiltered pneumatic nebulizer, non-disposable

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7004. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the A7004 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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