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See a sample rate comparisonHCPCS K0455 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
| Key Fact | Detail |
|---|---|
| Service Type | Durable medical equipment (DME) Medicare administrative contractors (MACs) INFUSION PUMPS AND SUPPLIES |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for K0455 |
National average reimbursement for HCPCS K0455 by major payers:
$2,091.09
$217.13
$958.95
$4,613.17
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HCPCS K0455
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$575.41Published rateChu Chen
$307.17Published rateBacon County Health Services, Inc, Bacon County Rural Health Clinic
Bacon County Health Services Inc
$179.08Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$156.92Published rateAlicia Encinas
Miguel A Arenas Md PC
$104.62Published rate
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See a sample payer proposalHCPCS K0455 vs. Other INFUSION PUMPS AND SUPPLIES Codes
The HCPCS K0455 code is part of the Durable medical equipment (DME) Medicare administrative contractors (MACs) services used for INFUSION PUMPS AND SUPPLIES. 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 K0455 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 |
|---|---|---|
| K0195-HCPCS | Low | Elevating leg rests, pair (for use with capped rental wheelchair base) |
| K0455-HCPCS | High | Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol) |
| K0462-HCPCS | Low | Temporary replacement for patient owned equipment being repaired, any type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0455. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0455 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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