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HCPCS V5262 Fee Schedule

Last Verified: October 2025

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.

Hearing aid, disposable, any type, monaural
Key FactDetail
Service Type

Hearing Services

Hearing Aids

Common Place of Service
Common Modifiers
Complexity LevelModerate

National average reimbursement for HCPCS V5262 by major payers:

bcbs

$883.29

uhc

$2,515.03

aetna

$339.48

cigna

$178.44

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For billing codeHCPCS V5262
PayerCodeRateNPITax IDStateSpecialty

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HCPCS V5262 vs. Other Hearing Aids Codes

The HCPCS V5262 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 V5262 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.

CodeComplexityDescription
V5261HighHearing aid, digital, binaural, BTE
V5262ModerateHearing aid, disposable, any type, monaural
V5263HighHearing aid, disposable, any type, binaural

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS V5262. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the V5262 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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Medicare Reimbursement Lookup Tool

Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)

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YearBilling CodeLocalityNon-Facility FeeFacility Fee