HCPCS code A4264: Contraceptive implant, permanent intratubal2026 Medicare rate & RVUs in New Jersey
A4264 identifies the permanent implantable device and delivery system used for hysteroscopic occlusion of the fallopian tubes for contraception.
CMS doesn’t publish an office rate for A4264 in New Jersey.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What A4264 covers
A4264 identifies a permanent implantable contraceptive device and delivery system used to occlude the fallopian tubes. The device is placed hysteroscopically through the cervix and uterus, with the implants positioned in the tubes. Gynecologists may report the device with the hysteroscopic service represented by CPT 58565. It differs from barrier methods such as a cervical cap, diaphragm, or condom, which do not permanently occlude the tubes.
For Medicare, A4264 has physician fee schedule status I: it is not valid for Medicare, which uses a different code to report and pay for the service. CMS also classifies A4264 as not separately priced under Medicare Part B, and its HCPCS coverage code marks it not payable by Medicare. A4264 represents the implantable device or devices and delivery system, not a medication. CPT 58565 identifies the associated hysteroscopic placement procedure.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where A4264 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | Unavailable | Unavailable |
| Rest of New Jersey | Unavailable | Unavailable |
How the A4264 rate is calculated
Each of A4264’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · A4264
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for A4264
A4264 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · A4264
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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A4264 isn’t priced in this setting.
A4264 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 58565Hysteroscopic sterilizationBilateral tubal implants
- A4264 identifies the implant device and delivery system; CPT 58565 identifies the hysteroscopic procedure used to place permanent implants for tubal occlusion.
- A4261Cervical capContraceptive use
- A4261 identifies a cervical cap, a barrier contraceptive. A4264 identifies a permanent intratubal implant and delivery system.
- A4266DiaphragmContraceptive use
- A4266 identifies a diaphragm used as a barrier contraceptive; A4264 is for permanent tubal occlusion.
- A4267Male condomEach
- A4267 identifies a male condom, a barrier contraceptive; A4264 identifies a permanent intratubal device and delivery system.
A4264 billing questions
What does A4264 identify?
It identifies a permanent implantable contraceptive device and its delivery system for occluding the fallopian tubes.
How is A4264 different from CPT 58565?
A4264 identifies the device and delivery system. CPT 58565 identifies the hysteroscopic placement procedure.
Does Medicare pay for A4264?
No. A4264 is not valid for Medicare under status I, and its HCPCS coverage code marks it not payable by Medicare.
Is A4264 separately priced under Medicare Part B?
No. CMS classifies A4264 as not separately priced under Medicare Part B.
Is A4264 the same as a cervical cap or diaphragm?
No. A4264 identifies a permanent intratubal device; a cervical cap and diaphragm are barrier contraceptives.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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