Fee Schedules
Payer rate schedules by HCPCS code
| HCPCS Code | Product | Payer | Allowed Amount | Effective Date |
|---|---|---|---|---|
| A6530 | Compression Stocking BK 18-30mmHg | Medicare | $38.00 | Jan 1, 2026 |
| A6531 | Compression Stocking BK 30-40mmHg | Medicare | $48.00 | Jan 1, 2026 |
| A6534 | Compression Stocking Thigh 30-40mmHg | Medicare | $62.00 | Jan 1, 2026 |
| A6549 | Compression Garment NOS | Medicare | $78.00 | Jan 1, 2026 |
| A6448 | Light Compression Bandage Elastic | Medicare | $4.50 | Jan 1, 2026 |
| A6449 | Light Compression Bandage Non-Elastic | Medicare | $10.00 | Jan 1, 2026 |
| E0652 | Pneumatic Compressor Segmental | Medicare | $1,200.00 | Jan 1, 2026 |
| E0667 | Segmental Appliance Full Leg | Medicare | $245.00 | Jan 1, 2026 |
| L8030 | Breast Prosthesis Silicone | Medicare | $285.00 | Jan 1, 2026 |
| L8000 | Mastectomy Bra | Medicare | $42.00 | Jan 1, 2026 |
| A6530 | Compression Stocking BK 18-30mmHg | Anthem Blue Cross | $43.70 | Jan 1, 2026 |
| A6531 | Compression Stocking BK 30-40mmHg | Anthem Blue Cross | $55.20 | Jan 1, 2026 |
| A6534 | Compression Stocking Thigh 30-40mmHg | Anthem Blue Cross | $71.30 | Jan 1, 2026 |
| A6549 | Compression Garment NOS | Anthem Blue Cross | $89.70 | Jan 1, 2026 |
| A6448 | Light Compression Bandage Elastic | Anthem Blue Cross | $5.18 | Jan 1, 2026 |
| A6449 | Light Compression Bandage Non-Elastic | Anthem Blue Cross | $11.50 | Jan 1, 2026 |
| E0652 | Pneumatic Compressor Segmental | Anthem Blue Cross | $1,380.00 | Jan 1, 2026 |
| E0667 | Segmental Appliance Full Leg | Anthem Blue Cross | $281.75 | Jan 1, 2026 |
| L8030 | Breast Prosthesis Silicone | Anthem Blue Cross | $327.75 | Jan 1, 2026 |
| L8000 | Mastectomy Bra | Anthem Blue Cross | $48.30 | Jan 1, 2026 |
| A6530 | Compression Stocking BK 18-30mmHg | Aetna | $41.80 | Jan 1, 2026 |
| A6531 | Compression Stocking BK 30-40mmHg | Aetna | $52.80 | Jan 1, 2026 |
| A6534 | Compression Stocking Thigh 30-40mmHg | Aetna | $68.20 | Jan 1, 2026 |
| A6549 | Compression Garment NOS | Aetna | $85.80 | Jan 1, 2026 |
| A6448 | Light Compression Bandage Elastic | Aetna | $4.95 | Jan 1, 2026 |
| A6449 | Light Compression Bandage Non-Elastic | Aetna | $11.00 | Jan 1, 2026 |
| E0652 | Pneumatic Compressor Segmental | Aetna | $1,320.00 | Jan 1, 2026 |
| E0667 | Segmental Appliance Full Leg | Aetna | $269.50 | Jan 1, 2026 |
| L8030 | Breast Prosthesis Silicone | Aetna | $313.50 | Jan 1, 2026 |
| L8000 | Mastectomy Bra | Aetna | $46.20 | Jan 1, 2026 |
| A6530 | Compression Stocking BK 18-30mmHg | UnitedHealthcare | $42.56 | Jan 1, 2026 |
| A6531 | Compression Stocking BK 30-40mmHg | UnitedHealthcare | $53.76 | Jan 1, 2026 |
| A6534 | Compression Stocking Thigh 30-40mmHg | UnitedHealthcare | $69.44 | Jan 1, 2026 |
| A6549 | Compression Garment NOS | UnitedHealthcare | $87.36 | Jan 1, 2026 |
| A6448 | Light Compression Bandage Elastic | UnitedHealthcare | $5.04 | Jan 1, 2026 |
| A6449 | Light Compression Bandage Non-Elastic | UnitedHealthcare | $11.20 | Jan 1, 2026 |
| E0652 | Pneumatic Compressor Segmental | UnitedHealthcare | $1,344.00 | Jan 1, 2026 |
| E0667 | Segmental Appliance Full Leg | UnitedHealthcare | $274.40 | Jan 1, 2026 |
| L8030 | Breast Prosthesis Silicone | UnitedHealthcare | $319.20 | Jan 1, 2026 |
| L8000 | Mastectomy Bra | UnitedHealthcare | $47.04 | Jan 1, 2026 |
| A6530 | Compression Stocking BK 18-30mmHg | Cigna | $41.04 | Jan 1, 2026 |
| A6531 | Compression Stocking BK 30-40mmHg | Cigna | $51.84 | Jan 1, 2026 |
| A6534 | Compression Stocking Thigh 30-40mmHg | Cigna | $66.96 | Jan 1, 2026 |
| A6549 | Compression Garment NOS | Cigna | $84.24 | Jan 1, 2026 |
| A6448 | Light Compression Bandage Elastic | Cigna | $4.86 | Jan 1, 2026 |
| A6449 | Light Compression Bandage Non-Elastic | Cigna | $10.80 | Jan 1, 2026 |
| E0652 | Pneumatic Compressor Segmental | Cigna | $1,296.00 | Jan 1, 2026 |
| E0667 | Segmental Appliance Full Leg | Cigna | $264.60 | Jan 1, 2026 |
| L8030 | Breast Prosthesis Silicone | Cigna | $307.80 | Jan 1, 2026 |
| L8000 | Mastectomy Bra | Cigna | $45.36 | Jan 1, 2026 |
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