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See a sample rate comparisonHCPCS V5130 Fee Schedule
Last Verified: September 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.
Binaural, in the ear
| Key Fact | Detail |
|---|---|
| Service Type | Hearing Services Hearing Aids |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for V5130 |
National average reimbursement for HCPCS V5130 by major payers:
$1,332.62
$1,450.92
$1,020.57
$924.44
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HCPCS V5130
5 of 25 sample ratesHigher to lower in this preview
Emory Crawford Long Hospital
Emory University
$7,388.45Published rateChu Chen
$2,832.48Published rateTift Regional Health System Inc., Tift Regional Medical Center
Tift Regional Health System Inc
$1,809.88Published rateUpson County Hospital Inc, Upson Regional Medical Center
Upson County Hospital Inc
$1,510.18Published rateMichael Koch
Pathology Lab Of Georgia LLC
$1,132.48Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS V5130 vs. Other Hearing Aids Codes
The HCPCS V5130 code is part of the Hearing Services services used for Hearing Aids. 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 V5130 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 |
|---|---|---|
| V5120-HCPCS | High | Binaural, body |
| V5130-HCPCS | High | Binaural, in the ear |
| V5140-HCPCS | High | Binaural, behind the ear |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V5130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the V5130 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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