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See a sample rate comparisonHCPCS S5553 (Lantus Solostar Pen) 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.
Insulin, long acting; 5 units
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Insulin and Delivery Devices |
| Common Place of Service | None 99 - Other POS 23 - Emergency Room |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for S5553 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS S5553 by major payers:
$0.48
$0.58
$1.46
$0.60
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HCPCS S5553
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$0.98Published rateHospital Authority Of Candler County, Candler County Hospital
$0.58Published ratePiedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$0.58Published rateAnn Bowers
Franciscan Medical Group
$0.58Published rateEmory Healthcare
Emory University
$0.34Published rate
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See a sample payer proposalHCPCS S5553 vs. Other Insulin and Delivery Devices Codes
The HCPCS S5553 code is part of the Temporary National Codes (Non-Medicare) services used for Insulin and Delivery Devices. 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 S5553 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 |
|---|---|---|
| S5552-HCPCS | Low | Insulin, intermediate acting (NPH or LENTE); 5 units |
| S5553-HCPCS | Low | Insulin, long acting; 5 units |
| S5560-HCPCS | Low | Insulin delivery device, reusable pen; 1.5 ml size |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S5553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S5553 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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