HCPCS S2235 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Miscellaneous Provider Services and Supplies |
| Common Place of Service | 21 - Inpatient Hospital |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for S2235 |
National average reimbursement for HCPCS S2235 by major payers:
$2,244.92
$379.42
$391.22
$159.00
HCPCS S2235 vs. Other Miscellaneous Provider Services and Supplies Codes
The HCPCS S2235 code is part of the Temporary National Codes (Non-Medicare) services used for Miscellaneous Provider Services 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 S2235 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 |
|---|---|---|
| S2230-HCPCS | Moderate | Implantation of magnetic component of semi-implantable hearing device on ossicles in middle ear |
| S2235-HCPCS | High | Implantation of auditory brain stem implant |
| S2260-HCPCS | Moderate | Induced abortion, 17 to 24 weeks |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S2235. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S2235 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS S2235) and we'll show you how you compare in 15 minutes or less.