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See a sample rate comparisonHCPCS Q4004 Fee Schedule
Last Verified: October 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.
Cast supplies, shoulder cast, adult (11 years +), fiberglass
| Key Fact | Detail |
|---|---|
| Service Type | Temporary Codes Cast and Splint Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for Q4004 |
National average reimbursement for HCPCS Q4004 by major payers:
$124.33
$81.13
$111.57
$119.15
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HCPCS Q4004
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
$278.04Published rateChristopher Raio
Mercy Medical Center
$126.38Published rateSteven Clark
Attigo Infusion Inc
$75.15Published rateMichael Koch
Pathology Lab Of Georgia LLC
$64.44Published rateMiguel A. Arenas, M.D., PC
Miguel A Arenas Md PC
$42.97Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS Q4004 vs. Other Cast and Splint Supplies Codes
The HCPCS Q4004 code is part of the Temporary Codes services used for Cast and Splint 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 Q4004 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 |
|---|---|---|
| Q4003-HCPCS | Low | Cast supplies, shoulder cast, adult (11 years +), plaster |
| Q4004-HCPCS | Low | Cast supplies, shoulder cast, adult (11 years +), fiberglass |
| Q4005-HCPCS | Low | Cast supplies, long arm cast, adult (11 years +), plaster |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS Q4004. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the Q4004 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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