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See a sample rate comparisonHealthcare 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 | Enteral and Parenteral Therapy Enteral Feeding Supplies and Equipment |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for B4035 |
National average reimbursement for HCPCS B4035 by major payers:

$7.78

$9.88

$7.43

$8.05
Choose a payer to see a sample of rates for HCPCS B4035.
Childrens Healthcare Of Atlanta Inc
Merrimack Valley Pediatric Associates, Inc.
Borbas Surgical Supply Inc
Childrens Hospital
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS B4035 vs. Other Enteral Feeding Supplies and Equipment Codes
The HCPCS B4035 code is part of the Enteral and Parenteral Therapy services used for Enteral Feeding Supplies and Equipment. 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 B4035 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 |
|---|---|---|
| B4034-HCPCS | Low | Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
| B4035-HCPCS | Low | Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
| B4036-HCPCS | Low | Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS B4035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the B4035 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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