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See a sample rate comparisonHCPCS A7028 Fee Schedule
HCPCS A7028 is classified under Medical And Surgical Supplies, in the Breathing Aids subgroup.
Oral cushion for combination oral/nasal mask, replacement only, each
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Breathing Aids |
| Complexity Level | Low |
| Medicaid Fee Schedule | $43.48 median of the 7 states in the free preview · View Medicaid rates for A7028 |
National average reimbursement for HCPCS A7028 by major payers:
$38.39
BCBS / Anthem
$31.27
UnitedHealthcare
$39.52
Aetna
$51.02
Cigna
Compare published rates across providers.
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HCPCS A7028
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$86.23Published rateUnion County Hospital Authority, Union General Hospital
Union County Hospital Authority
$40.02Published rateArthur M. Blank Hospital, Inc., Arthur M. Blank Hospital
Childrens Healthcare Of Atlanta Inc
$32.02Published rateNortheast Georgia Medical Center, Inc.
Gainesville Radiology Group
$23.05Published rateAlicia Encinas
Miguel A Arenas Md PC
$15.36Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A7028 vs. Other Breathing Aids Codes
The table lists codes related to A7028. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A7027-HCPCS | Low | Combination oral/nasal mask, used with continuous positive airway pressure device, each |
| A7028-HCPCS | Low | Oral cushion for combination oral/nasal mask, replacement only, each |
| A7029-HCPCS | Low | Nasal pillows for combination oral/nasal mask, replacement only, pair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7028. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7028 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.
FREE SAMPLE MARKET COMPARISON
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