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See a sample rate comparisonHCPCS S4011 Fee Schedule
Last Verified: October 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.
In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Assorted Obstetrical and Fertility Services |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center None |
| Complexity Level | High |
National average reimbursement for HCPCS S4011 by major payers:
$3,125.28
$889.36
$5,450.14
$5,146.55
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS S4011.
HCPCS S4011
5 of 8 sample ratesHigher to lower in this preview
Sara Kostant
Healthworks Med Group Of Texas Darlington P A / Medical Offices Of Occupational Health Resources P C / Premise Health Of California Medical PC
$3,961.00Published rateCaroline Friedman
Healthworks Med Group Of Texas Darlington P A / Medical Offices Of Occupational Health Resources P C / Premise Health Of California Medical PC
$3,961.00Published rateCaroline Friedman
Premise Health Of New York Medical PC
$3,961.00Published rateCaroline Friedman
Healthworks Med Group Of Texas Darlington P A / Medical Offices Of Occupational Health Resources P C / Premise Health Of California Medical PC
$3,961.00Published rateCaroline Friedman
Premise Health Of New York Medical PC
$3,961.00Published rate
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See a sample payer proposalHCPCS S4011 vs. Other Assorted Obstetrical and Fertility Services Codes
The HCPCS S4011 code is part of the Temporary National Codes (Non-Medicare) services used for Assorted Obstetrical and Fertility Services. 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 S4011 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 |
|---|---|---|
| S4005-HCPCS | Low | Interim labor facility global (labor occurring but not resulting in delivery) |
| S4011-HCPCS | High | In vitro fertilization; including but not limited to identification and incubation of mature oocytes, fertilization with sperm, incubation of embryo(s), and subsequent visualization for determination of development |
| S4013-HCPCS | High | Complete cycle, gamete intrafallopian transfer (GIFT), case rate |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S4011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S4011 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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