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HCPCS A7004 Fee Schedule

Last Verified: November 2025

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$0.541952776023 - KRISTINA JIMENEZ300394179 - (AZ) MIGUEL A ARENAS MD PCAZFamily Nurse Practitioner (363LF0000X)
United
A7004$0.541548859895 - ALICIA ENCINAS300394179 - (AZ) MIGUEL A ARENAS MD PCCAFamily Nurse Practitioner (363LF0000X)
United
A7004$1.021316561236 - CINDY CHANG300394179 - (AZ) MIGUEL A ARENAS MD PCAZFamily Nurse Practitioner (363LF0000X)
United
A7004$1.471063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
A7004$0.991205890076 - APRIL LEUZINGER271495988 - (NM) AZTEC URGENT CARE LLCCOPhysician Assistant (363A00000X)
United
A7004$0.991174512115 - MICHAEL GUILLETTE271495988 - (NM) AZTEC URGENT CARE LLCCOPhysician Assistant (363A00000X)
United
A7004$1.611063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
A7004$1.611063741163 - AZTEC URGENT CARE, LLC271495988 - (NM) AZTEC URGENT CARE LLCNMUrgent Care Clinic/Center (261QU0200X)
United
A7004$0.541619087590 - MIGUEL ARENAS300394179 - (AZ) MIGUEL A ARENAS MD PCAZGastroenterology Physician (207RG0100X)
United
A7004$0.811548859895 - ALICIA ENCINAS300394179 - (AZ) MIGUEL A ARENAS MD PCCAFamily Nurse Practitioner (363LF0000X)
United
A7004$0.811225339898 - SCREVEN COUNTY HOSPITAL, LLC, OPTIM MEDICAL CENTER - SCREVEN273100946GACritical Access Hospital (282NC0060X)
United
A7004$0.561235153883 - WILDWOOD SANITARIUM, INCORPORATED, WILDWOOD LIFESTYLE CENTER AND HOSPITAL586039864 - (GA) WILDWOOD SANITARIUM INCORPORATEDGAGeneral Acute Care Hospital (282N00000X)
United
A7004$0.811396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER586012329 - (GA) HOSPITAL AUTHORITY OF WASHINGTON COUNTYGARural Acute Care Hospital (282NR1301X)
United
A7004$0.991790715381 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL DULUTH582002413GAGeneral Acute Care Hospital (282N00000X)
United
A7004$2.751598964082 - EMORY HEALTHCARE582030692 - EMORY UNIVERSITYGAGeneral Acute Care Hospital (282N00000X)
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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