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See a sample rate comparisonHCPCS K0552 Fee Schedule
Last Verified: September 2026
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.
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
| Key Fact | Detail |
|---|---|
| Service Type | Durable medical equipment (DME) Medicare administrative contractors (MACs) INFUSION PUMPS AND SUPPLIES |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for K0552 |
National average reimbursement for HCPCS K0552 by major payers:
$2.87
$1.94
$2.19
$3.04
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HCPCS K0552
5 of 25 sample ratesHigher to lower in this preview
Scott & White Clinic
$2.83Published rateTexas Oncology PA
Us Oncology Corporate, Inc.
$1.74Published rateMontgomery Verona
Austin Neurological Clinic
$1.70Published rateProfessional Assn For Pediatrics
Professional Association For Pediatrics 401k Profit Sharing Plan
$1.66Published rateGerald Banks
Ely-Bloomenson Community Hospital
$1.14Published rate
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See a sample payer proposalHCPCS K0552 vs. Other INFUSION PUMPS AND SUPPLIES Codes
The HCPCS K0552 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 K0552 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 |
|---|---|---|
| K0462-HCPCS | Low | Temporary replacement for patient owned equipment being repaired, any type |
| K0552-HCPCS | Low | Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
| K0601-HCPCS | Low | Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS K0552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the K0552 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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