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See a sample rate comparisonHCPCS V5240 Fee Schedule
Last Verified: September 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.
Dispensing fee, contralateral routing system, binaural
| Key Fact | Detail |
|---|---|
| Service Type | Hearing Services Hearing Aids |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for V5240 |
National average reimbursement for HCPCS V5240 by major payers:
$207.01
$360.02
$251.97
$205.04
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HCPCS V5240
5 of 25 sample ratesHigher to lower in this preview
Scottish Rite Childrens Medical Ctr, Children'S Healthcare Of Atlanta At Scottish Rite
Childrens Healthcare Of Atlanta Inc
$908.59Published rateEmory Crawford Long Hospital
Emory University
$668.28Published rateHospital Authority Of Valdosta And Lowndes County Georgia, South Georgia Medical Center
Hospital Authority Of Valdosta And Lowndes County Georgia
$450.07Published rateChatuge Regional Hospital Inc
$373.95Published rateMeriwether Healthcare, L.L.C., Warm Springs Medical Center
Meriwether Healthcare, LLC D/B/A Warm Springs Medical Center
$281.29Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS V5240 vs. Other Hearing Aids Codes
The HCPCS V5240 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 V5240 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 |
|---|---|---|
| V5230-HCPCS | High | Hearing aid, contralateral routing system, binaural, glasses |
| V5240-HCPCS | Moderate | Dispensing fee, contralateral routing system, binaural |
| V5241-HCPCS | Moderate | Dispensing fee, monaural hearing aid, any type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V5240. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the V5240 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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