Ostomy, Tracheostomy & Urologicals - 2006 Region A DMERC Fee Schedule
(Click here for a text version of this fee schedule.)

HCPCSMOD1MOD2CeilingFloorCTDEMAMENHNJNYPARIVT
A4216  $0.45$0.38$0.45$0.45$0.45$0.45$0.45$0.45$0.41$0.45$0.40$0.45
A4217AU $3.13$2.66$3.13$3.13$2.66$2.66$2.66$3.13$2.66$3.13$2.66$3.05
A4310  $7.72$6.56$7.72$7.14$7.72$7.72$7.72$7.14$7.72$7.14$7.72$7.72
A4311  $14.84$12.61$13.90$12.61$13.97$13.97$13.30$12.61$13.53$12.61$12.61$13.82
A4312  $18.04$15.33$15.33$15.33$15.33$15.33$15.33$15.33$15.33$15.33$15.33$15.33
A4313  $18.52$15.74$18.52$18.15$15.74$15.74$15.74$18.15$18.52$18.15$15.74$15.74
A4314  $25.29$21.50$25.29$24.01$21.50$21.50$21.50$24.01$24.40$24.01$21.50$21.50
A4315  $26.39$22.43$22.43$25.80$22.43$22.43$22.43$25.80$26.39$25.80$22.43$22.43
A4316  $28.40$24.14$24.14$26.95$28.40$28.40$27.74$26.95$28.40$26.95$26.10$28.40
A4320  $5.33$4.53$5.33$5.04$5.33$5.33$5.33$5.04$4.89$5.04$5.33$5.33
A4321  $0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
A4322  $3.04$2.58$3.04$2.94$3.04$3.04$3.04$2.94$3.04$2.94$3.04$3.04
A4326  $10.79$9.17$10.37$10.79$10.37$10.37$10.37$10.79$9.17$10.79$10.37$10.37
A4327  $44.62$37.93$42.27$42.27$42.27$42.27$42.27$42.27$42.27$42.27$42.27$42.27
A4328  $10.45$8.88$8.88$10.45$8.88$8.88$8.88$10.45$10.45$10.45$9.86$8.88
A4330  $7.15$6.08$7.15$7.15$7.15$7.15$7.15$7.15$6.08$7.15$6.79$7.15
A4331  $3.18$2.70$3.18$3.18$3.18$3.18$3.18$3.18$3.18$3.18$3.18$3.18
A4332  $0.12$0.10$0.12$0.12$0.12$0.12$0.12$0.12$0.12$0.12$0.12$0.12
A4333  $2.20$1.87$2.20$2.20$2.20$2.20$2.20$2.20$2.20$2.20$2.20$2.20
A4334  $4.93$4.19$4.93$4.93$4.93$4.93$4.93$4.93$4.93$4.93$4.93$4.93
A4338  $12.26$10.42$11.81$10.56$12.26$12.26$12.26$10.56$10.42$10.56$11.64$12.26
A4340  $31.75$26.99$31.75$31.75$31.75$31.75$30.35$31.75$31.75$31.75$31.75$31.75
A4344  $16.02$13.62$13.62$13.62$15.20$16.02$16.02$13.62$16.02$13.62$14.07$16.02
A4346  $19.59$16.65$19.59$17.05$19.59$16.65$16.65$17.05$17.76$17.05$16.65$16.65
A4348  $27.83$23.66$27.83$27.83$27.83$27.83$27.83$27.83$27.83$27.83$27.83$27.83
A4349  $2.02$1.72$2.02$2.02$2.02$2.02$2.02$2.02$2.02$2.02$2.02$2.02
A4351  $1.81$1.54$1.81$1.74$1.81$1.81$1.81$1.74$1.54$1.74$1.81$1.81
A4352  $6.42$5.46$6.42$6.42$6.42$6.42$6.42$6.42$6.42$6.42$5.46$6.42
A4353  $7.00$5.95$6.99$6.99$6.99$6.99$6.99$6.99$6.99$6.99$6.99$6.99
A4354  $11.80$10.03$11.80$11.70$11.80$11.80$10.03$11.70$10.03$11.70$11.80$10.03
A4355  $8.91$7.57$8.91$8.91$7.57$7.57$7.57$8.91$8.91$8.91$8.91$7.57
A4356  $45.63$38.79$45.63$45.63$38.79$38.79$38.79$45.63$38.79$45.63$38.79$38.79
A4357  $9.70$8.25$9.34$9.19$8.25$8.25$9.70$9.19$9.70$9.19$8.25$8.25
A4358  $6.63$5.64$6.63$6.63$6.63$5.93$5.64$6.63$6.28$6.63$6.63$6.63
A4359  $30.63$26.04$29.37$30.63$27.21$27.21$27.21$30.63$30.45$30.63$26.04$27.21
A4361  $18.37$15.61$15.61$18.26$17.83$17.83$17.83$18.26$15.61$18.26$16.91$17.83
A4362  $3.46$2.94$3.46$3.46$2.94$3.16$3.46$3.46$3.46$3.46$3.46$2.94
A4363  $2.36$2.01$2.27$2.36$2.36$2.01$2.01$2.36$2.01$2.36$2.27$2.01
A4364  $2.93$2.49$2.93$2.93$2.89$2.93$2.93$2.93$2.93$2.93$2.89$2.93
A4365  $11.32$9.62$11.32$11.32$11.32$11.32$11.32$11.32$11.32$11.32$11.32$11.32
A4366  $1.30$1.11$1.30$1.30$1.30$1.30$1.30$1.30$1.30$1.30$1.30$1.30
A4367  $7.35$6.25$7.35$7.35$6.62$7.35$7.06$7.35$6.85$7.35$7.35$6.25
A4368  $0.26$0.22$0.26$0.26$0.26$0.26$0.26$0.26$0.26$0.26$0.26$0.26
A4369  $2.42$2.06$2.42$2.42$2.42$2.42$2.42$2.42$2.42$2.42$2.42$2.42
A4371  $3.65$3.10$3.65$3.65$3.65$3.65$3.65$3.65$3.65$3.65$3.65$3.65
A4372  $4.18$3.55$4.18$4.18$4.18$4.18$4.18$4.18$4.18$4.18$4.18$4.18
A4373  $6.28$5.34$6.28$6.28$6.28$6.28$6.28$6.28$6.28$6.28$6.28$6.28
A4375  $17.18$14.60$17.18$17.18$17.18$17.18$17.18$17.18$17.18$17.18$17.18$17.18
A4376  $47.58$40.44$47.58$47.58$47.58$47.58$47.58$47.58$47.58$47.58$47.58$47.58
A4377  $4.29$3.65$4.29$4.29$4.29$4.29$4.29$4.29$4.29$4.29$4.29$4.29
A4378  $30.75$26.14$30.75$30.75$30.75$30.75$30.75$30.75$30.75$30.75$30.75$30.75
A4379  $15.02$12.77$15.02$15.02$15.02$15.02$15.02$15.02$15.02$15.02$15.02$15.02
A4380  $37.33$31.73$37.33$37.33$37.33$37.33$37.33$37.33$37.33$37.33$37.33$37.33
A4381  $4.61$3.92$4.61$4.61$4.61$4.61$4.61$4.61$4.61$4.61$4.61$4.61
A4382  $24.62$20.93$24.62$24.62$24.62$24.62$24.62$24.62$24.62$24.62$24.62$24.62
A4383  $28.19$23.96$28.19$28.19$28.19$28.19$28.19$28.19$28.19$28.19$28.19$28.19
A4384  $9.62$8.18$9.62$9.62$9.62$9.62$9.62$9.62$9.62$9.62$9.62$9.62
A4385  $5.10$4.34$5.10$5.10$5.10$5.10$5.10$5.10$5.10$5.10$5.10$5.10
A4387  $0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
A4388  $4.36$3.71$4.36$4.36$4.36$4.36$4.36$4.36$4.36$4.36$4.36$4.36
A4389  $6.22$5.29$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22
A4390  $9.61$8.17$9.61$9.61$9.61$9.61$9.61$9.61$9.61$9.61$9.61$9.61
A4391  $7.07$6.01$7.07$7.07$7.07$7.07$7.07$7.07$7.07$7.07$7.07$7.07
A4392  $8.18$6.95$8.18$8.18$8.18$8.18$8.18$8.18$8.18$8.18$8.18$8.18
A4393  $9.04$7.68$9.04$9.04$9.04$9.04$9.04$9.04$9.04$9.04$9.04$9.04
A4394  $2.58$2.19$2.58$2.58$2.58$2.58$2.58$2.58$2.58$2.58$2.58$2.58
A4395  $0.05$0.04$0.05$0.05$0.05$0.05$0.05$0.05$0.05$0.05$0.05$0.05
A4396  $40.48$34.41$40.48$40.48$40.48$40.48$40.48$40.48$40.48$40.48$40.48$40.48
A4397  $4.79$4.07$4.07$4.79$4.07$4.07$4.07$4.79$4.24$4.79$4.16$4.07
A4398  $13.81$11.74$13.81$13.81$13.56$13.56$12.88$13.81$13.81$13.81$12.88$13.40
A4399  $12.26$10.42$12.26$12.26$12.26$12.26$11.87$12.26$12.26$12.26$11.03$12.26
A4400  $48.87$41.54$48.87$48.87$48.87$48.87$48.87$48.87$41.54$48.87$41.54$48.87
A4402  $1.60$1.36$1.36$1.39$1.36$1.60$1.36$1.39$1.60$1.39$1.36$1.53
A4404  $1.69$1.44$1.69$1.60$1.69$1.44$1.62$1.54$1.69$1.60$1.62$1.51
A4405  $3.40$2.89$3.40$3.40$3.40$3.40$3.40$3.40$3.40$3.40$3.40$3.40
A4406  $5.74$4.88$5.74$5.74$5.74$5.74$5.74$5.74$5.74$5.74$5.74$5.74
A4407  $8.76$7.45$8.76$8.76$8.76$8.76$8.76$8.76$8.76$8.76$8.76$8.76
A4408  $9.87$8.39$9.87$9.87$9.87$9.87$9.87$9.87$9.87$9.87$9.87$9.87
A4409  $6.22$5.29$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22
A4410  $9.04$7.68$9.04$9.04$9.04$9.04$9.04$9.04$9.04$9.04$9.04$9.04
A4411  $5.10$4.34$5.10$5.10$5.10$5.10$5.10$5.10$5.10$5.10$5.10$5.10
A4412  $2.70$2.30$2.70$2.70$2.70$2.70$2.70$2.70$2.70$2.70$2.70$2.70
A4413  $5.50$4.68$5.50$5.50$5.50$5.50$5.50$5.50$5.50$5.50$5.50$5.50
A4414  $4.93$4.19$4.93$4.93$4.93$4.93$4.93$4.93$4.93$4.93$4.93$4.93
A4415  $6.00$5.10$6.00$6.00$6.00$6.00$6.00$6.00$6.00$6.00$6.00$6.00
A4416  $2.75$2.34$2.75$2.75$2.75$2.75$2.75$2.75$2.75$2.75$2.75$2.75
A4417  $3.72$3.16$3.72$3.72$3.72$3.72$3.72$3.72$3.72$3.72$3.72$3.72
A4418  $1.81$1.54$1.81$1.81$1.81$1.81$1.81$1.81$1.81$1.81$1.81$1.81
A4419  $1.74$1.48$1.74$1.74$1.74$1.74$1.74$1.74$1.74$1.74$1.74$1.74
A4420  $0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
A4422  $0.12$0.10$0.12$0.12$0.12$0.12$0.12$0.12$0.12$0.12$0.12$0.12
A4423  $1.86$1.58$1.86$1.86$1.86$1.86$1.86$1.86$1.86$1.86$1.86$1.86
A4424  $4.75$4.04$4.75$4.75$4.75$4.75$4.75$4.75$4.75$4.75$4.75$4.75
A4425  $3.58$3.04$3.58$3.58$3.58$3.58$3.58$3.58$3.58$3.58$3.58$3.58
A4426  $2.73$2.32$2.73$2.73$2.73$2.73$2.73$2.73$2.73$2.73$2.73$2.73
A4427  $2.78$2.36$2.78$2.78$2.78$2.78$2.78$2.78$2.78$2.78$2.78$2.78
A4428  $6.51$5.53$6.51$6.51$6.51$6.51$6.51$6.51$6.51$6.51$6.51$6.51
A4429  $8.25$7.01$8.25$8.25$8.25$8.25$8.25$8.25$8.25$8.25$8.25$8.25
A4430  $8.52$7.24$8.52$8.52$8.52$8.52$8.52$8.52$8.52$8.52$8.52$8.52
A4431  $6.22$5.29$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22$6.22
A4432  $3.59$3.05$3.59$3.59$3.59$3.59$3.59$3.59$3.59$3.59$3.59$3.59
A4433  $3.34$2.84$3.34$3.34$3.34$3.34$3.34$3.34$3.34$3.34$3.34$3.34
A4434  $3.76$3.20$3.76$3.76$3.76$3.76$3.76$3.76$3.76$3.76$3.76$3.76
A4450AU $0.09$0.08$0.09$0.09$0.09$0.09$0.09$0.09$0.09$0.09$0.09$0.09
A4450AV $0.09$0.08$0.09$0.09$0.09$0.09$0.09$0.09$0.09$0.09$0.09$0.09
A4450AW $0.11$0.09$0.11$0.11$0.11$0.11$0.11$0.11$0.11$0.11$0.11$0.11
A4452AU $0.36$0.31$0.36$0.36$0.36$0.36$0.36$0.36$0.36$0.36$0.36$0.36
A4452AV $0.36$0.31$0.36$0.36$0.36$0.36$0.36$0.36$0.36$0.36$0.36$0.36
A4452AW $0.40$0.34$0.40$0.40$0.40$0.40$0.40$0.40$0.40$0.40$0.40$0.40
A4455  $1.43$1.22$1.43$1.40$1.43$1.43$1.43$1.40$1.22$1.40$1.43$1.43
A4481  $0.38$0.32$0.37$0.37$0.37$0.37$0.37$0.37$0.37$0.37$0.37$0.37
A4483  $0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00$0.00
A4623  $6.55$5.57$6.55$6.55$6.55$6.55$6.55$6.55$6.55$6.55$5.94$6.55
A4625  $6.93$5.89$6.93$6.93$5.89$5.89$5.89$6.93$6.93$6.93$6.68$5.89
A4626  $3.19$2.71$3.19$3.19$3.19$3.19$3.19$3.19$3.19$3.19$3.19$3.19
A4629  $4.63$3.94$4.63$4.63$4.63$4.63$4.63$4.63$4.63$4.63$4.63$4.63
A5051  $2.07$1.76$2.07$2.07$2.07$2.07$2.07$2.07$2.07$2.07$2.07$2.07
A5052  $1.49$1.27$1.49$1.49$1.49$1.49$1.49$1.49$1.49$1.49$1.49$1.49
A5053  $1.74$1.48$1.48$1.74$1.49$1.57$1.63$1.74$1.65$1.74$1.74$1.69
A5054  $1.79$1.52$1.79$1.79$1.79$1.79$1.79$1.79$1.79$1.79$1.79$1.79
A5055  $1.44$1.22$1.42$1.42$1.44$1.44$1.44$1.42$1.42$1.42$1.42$1.44
A5061  $3.52$2.99$3.52$3.52$3.52$3.52$3.52$3.52$3.52$3.52$3.52$3.52
A5062  $2.22$1.89$2.22$2.22$2.22$2.22$2.22$2.22$2.22$2.22$2.22$2.22
A5063  $2.70$2.30$2.70$2.70$2.70$2.70$2.70$2.70$2.70$2.70$2.70$2.70
A5071  $6.01$5.11$6.01$6.01$6.01$6.01$6.01$6.01$6.01$6.01$6.01$6.01
A5072  $3.52$2.99$3.43$3.52$3.52$3.52$3.52$3.52$3.52$3.52$3.43$3.52
A5073  $3.18$2.70$3.13$3.18$3.18$3.18$3.18$3.18$3.05$3.18$3.13$3.10
A5081  $3.30$2.81$3.30$3.30$3.30$3.30$3.30$3.30$3.30$3.30$3.30$3.30
A5082  $11.89$10.11$11.89$11.89$11.89$11.89$11.89$11.89$10.11$11.89$11.89$11.89
A5093  $1.95$1.66$1.95$1.94$1.95$1.95$1.86$1.94$1.78$1.94$1.95$1.94
A5102  $22.58$19.19$22.58$22.42$22.42$22.42$22.42$22.42$22.58$22.42$22.42$22.42
A5105  $40.76$34.65$40.76$40.76$34.65$34.65$34.65$40.76$40.76$40.76$40.76$34.65
A5112  $34.62$29.43$34.62$29.43$29.93$29.93$29.93$29.43$30.67$29.43$34.62$29.93
A5113  $4.70$4.00$4.00$4.70$4.47$4.47$4.47$4.70$4.70$4.70$4.00$4.47
A5114  $8.94$7.60$8.94$8.94$7.60$7.60$7.60$8.94$8.94$8.94$7.60$7.60
A5120AU $0.25$0.21$0.25$0.25$0.25$0.25$0.25$0.25$0.25$0.25$0.25$0.25
A5121  $7.46$6.34$7.46$6.54$7.39$7.39$7.04$6.54$6.34$6.54$7.46$7.34
A5122  $12.85$10.92$12.85$10.92$10.92$10.92$10.92$10.92$11.39$10.92$10.92$10.92
A5126  $1.32$1.12$1.32$1.32$1.32$1.32$1.32$1.32$1.12$1.32$1.32$1.32
A5131  $15.86$13.48$15.86$15.86$15.86$15.86$15.86$15.86$15.86$15.86$15.86$15.86
A5200  $11.30$9.61$11.30$11.30$11.30$11.30$11.30$11.30$11.30$11.30$11.30$11.30
A7501  $105.03$89.28$105.03$105.03$105.03$105.03$105.03$105.03$105.03$105.03$105.03$105.03
A7502  $49.91$42.42$49.91$49.91$49.91$49.91$49.91$49.91$49.91$49.91$49.91$49.91
A7503  $11.33$9.63$11.33$11.33$11.33$11.33$11.33$11.33$11.33$11.33$11.33$11.33
A7504  $0.67$0.57$0.67$0.67$0.67$0.67$0.67$0.67$0.67$0.67$0.67$0.67
A7505  $4.68$3.98$4.68$4.68$4.68$4.68$4.68$4.68$4.68$4.68$4.68$4.68
A7506  $0.33$0.28$0.33$0.33$0.33$0.33$0.33$0.33$0.33$0.33$0.33$0.33
A7507  $2.49$2.12$2.49$2.49$2.49$2.49$2.49$2.49$2.49$2.49$2.49$2.49
A7508  $2.87$2.44$2.87$2.87$2.87$2.87$2.87$2.87$2.87$2.87$2.87$2.87
A7509  $1.41$1.20$1.41$1.41$1.41$1.41$1.41$1.41$1.41$1.41$1.41$1.41
A7520  $47.48$40.36$47.48$47.48$47.48$47.48$47.48$47.48$47.48$47.48$47.48$47.48
A7521  $47.05$39.99$47.05$47.05$47.05$47.05$47.05$47.05$47.05$47.05$47.05$47.05
A7522  $45.16$38.39$45.16$45.16$45.16$45.16$45.16$45.16$45.16$45.16$45.16$45.16
A7524  $77.40$65.79$77.40$77.40$77.40$77.40$77.40$77.40$77.40$77.40$77.40$77.40
A7525  $2.07$1.76$2.07$2.07$2.07$2.07$2.07$2.07$2.07$2.07$2.07$2.07
A7526  $3.37$2.86$3.37$3.37$3.37$3.37$3.37$3.37$3.37$3.37$3.37$3.37
A7527  $3.58$3.04$3.58$3.58$3.58$3.58$3.58$3.58$3.58$3.58$3.58$3.58

Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.

Capped Rental   Frequently Serviced Items   Inexpensive/Routinely Purchased Items   Ostomy, Tracheostomy & Urologicals  
Oxygen & Oxygen Equipment   Prosthetics & Orthotics   Surgical Dressings   Supplies   TENS   Therapeutic Shoes  
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