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See a sample rate comparisonHCPCS V5221 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.
Hearing aid, contralateral routing system, binaural, bte/bte
| Key Fact | Detail |
|---|---|
| Service Type | Hearing Services Hearing Aids |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for V5221 |
National average reimbursement for HCPCS V5221 by major payers:
$2,120.20
$1,158.87
$5,409.32
$2,118.45
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HCPCS V5221
5 of 25 sample ratesHigher to lower in this preview
Emory University Hospital
Emory University
$2,417.79Published rateEmory Crawford Long Hospital
Emory University
$2,055.12Published rateHospital Authority Of Valdosta And Lowndes County Georgia, South Georgia Medical Center
Hospital Authority Of Valdosta And Lowndes County Georgia
$1,457.97Published rateProfessional Resources Management Of Rabun, LLC, Mountain Lakes Medical Center
$1,169.43Published rateHospital Authority Of Washington County, Washington County Regional Medical Center
Hospital Authority Of Washington County
$908.89Published rate
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See a sample payer proposalHCPCS V5221 vs. Other Hearing Aids Codes
The HCPCS V5221 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 V5221 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 |
|---|---|---|
| V5215-HCPCS | High | Hearing aid, contralateral routing system, binaural, itc/bte |
| V5221-HCPCS | High | Hearing aid, contralateral routing system, binaural, bte/bte |
| V5230-HCPCS | High | Hearing aid, contralateral routing system, binaural, glasses |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V5221. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the V5221 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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