HCPCS A7040 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 • Breathing Aids |
| Complexity Level | Low |
National average reimbursement for HCPCS A7040 by major payers:
$47.22
$30.63
$38.05
$44.93
| 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 A7040 | ||||||
United | A7040 | $28.35 | 1841651056 - KAMRAN RAJAEE | 273818647 | GA | General Acute Care Hospital (282N00000X) |
United | A7040 | $47.25 | 1528056066 - HAMILTON MEDICAL CENTER, INC. | 581519911 - HAMILTON MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | A7040 | $24.69 | 1457329435 - PAULDING MEDICAL CENTER, INC., WELLSTAR PAULDING HOSPITAL | 582095884 - (GA) PAULDING MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | A7040 | $100.89 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | A7040 | $28.35 | 1972731800 - MERIWETHER HEALTHCARE, L.L.C., WARM SPRINGS MEDICAL CENTER | 870764535 - (GA) MERIWETHER HEALTHCARE, LLC D/B/A WARM SPRINGS MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | A7040 | $23.29 | 1174512115 - MICHAEL GUILLETTE | 271495988 - (NM) AZTEC URGENT CARE LLC | CO | Physician Assistant (363A00000X) |
United | A7040 | $38.43 | 1770684284 - THE HOSPITAL AUTHORITY OF MONROE COUNTY, GEORGIA, MONROE COUNTY HOSPITAL | 586010602 - (GA) THE HOSPITAL AUTHORITY OF MONROE COUNTY GEORGIA | GA | Critical Access Hospital (282NC0060X) |
United | A7040 | $25.75 | 1982658944 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS | 721553462 | GA | General Acute Care Hospital (282N00000X) |
United | A7040 | $24.69 | 1720189517 - TAYLOR REGIONAL HOSPITAL | 580655369 - (GA) TAYLOR REGIONAL HOSPITAL | GA | Rural Acute Care Hospital (282NR1301X) |
United | A7040 | $28.35 | 1306136551 - UJUKA ILOABUCHI | 582422542 - ATLANTA WOMENS HEALTH GROUP, P.C. | GA | Women's Hospital (282NW0100X) |
United | A7040 | $27.17 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 586012329 - (GA) HOSPITAL AUTHORITY OF WASHINGTON COUNTY | GA | Rural Acute Care Hospital (282NR1301X) |
United | A7040 | $100.88 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | A7040 | $38.56 | 1902855216 - ATLANTA VAMC | 582091280 | GA | General Acute Care Hospital (282N00000X) |
United | A7040 | $26.69 | 1396770004 - HOSPITAL AUTHORITY OF WASHINGTON COUNTY, WASHINGTON COUNTY REGIONAL MEDICAL CENTER | 814817422 | GA | Rural Acute Care Hospital (282NR1301X) |
United | A7040 | $25.19 | 1093753386 - WILLAMETTE COMMUNITY HEALTH SOLUTIONS, CASCADE HEALTH SOLUTIONS | 930421470 | OR | Community Based Hospice Care Agency (251G00000X) |
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 A7040 vs. Other Breathing Aids Codes
The HCPCS A7040 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 A7040 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 |
|---|---|---|
| A7039-HCPCS | Low | Filter, non disposable, used with positive airway pressure device |
| A7040-HCPCS | Low | One way chest drain valve |
| A7041-HCPCS | Low | Water seal drainage container and tubing for use with implanted chest tube |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A7040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A7040 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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