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HCPCS code A4266: Diaphragm, contraceptive use2026 Medicare rate & RVUs

A4266 identifies a contraceptive diaphragm, a vaginal barrier supply used for pregnancy prevention, but Medicare does not accept this code for reporting.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · A4266

Diaphragm, contraceptive use

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for A4266 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What A4266 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What A4266 covers

A contraceptive diaphragm is a vaginal barrier device positioned over the cervix to help prevent pregnancy. It is used with spermicide and may be fitted or discussed during family-planning visits with an obstetrician-gynecologist, primary care clinician, or other reproductive health provider. It is placed before intercourse and removed afterward. The product may be supplied through a clinic or pharmacy; this code identifies the diaphragm supply, not a visit for counseling or fitting.

Medicare does not accept A4266 as a valid reporting code; its physician fee schedule status I means Medicare uses a different code to report and pay for the service. CMS classifies the item as not payable by Medicare and not separately priced under Part B.

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 A4266 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

A4266 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

A4266 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
A4266 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the A4266 rate is calculated

Each of A4266’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 · A4266

RVUs × geographic indexes × conversion factor

Office or facility?

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 A4266

A4266 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 · A4266

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

A4266 isn’t priced in this setting.

A4266 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • A4266

    Diaphragm, contraceptive use0 wRVU

    Not priced

  • A4261

    Cervical cap, contraceptive use0 wRVU

    Not priced

  • A4268

    Female condom, per condom0 wRVU

    Not priced

  • A4269

    Spermicide, each supply0 wRVU

    Not priced

How to choose

A4261Cervical capContraceptive use
Choose A4266 for a diaphragm and A4261 for a cervical cap; they are distinct vaginal barrier devices.
A4268Female condomPer condom
A4266 identifies a diaphragm placed over the cervix. A4268 identifies a female condom, a separate barrier method.
A4269SpermicideEach supply
A4266 is the diaphragm device; A4269 identifies spermicide, which may be used with the diaphragm but is not the device itself.

Codes related to A4266

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to A4266
CodeHow it relatesNational office range
Used instead
A4261Cervical cap, contraceptive useA cervical cap is a different barrier contraceptive used over the cervix.No office rate
A4267Male condom, eachA male condom is a different contraceptive barrier method.No office rate
A4268Female condom, per condomA female condom is a different contraceptive barrier method.No office rate
Often billed with
A4269Spermicide, each supplySpermicide may be used with a diaphragm as part of contraception.No office rate

A4266 billing questions

Does Medicare accept A4266?

No. Medicare does not accept A4266 as a valid reporting code and classifies the item as not payable.

How does a diaphragm differ from a cervical cap?

A4266 identifies a contraceptive diaphragm; A4261 identifies a cervical cap. They are distinct vaginal barrier devices.

Does A4266 identify spermicide?

No. A4266 identifies the diaphragm supply, while A4269 identifies spermicide, which may be used with a diaphragm.

Does A4266 describe a fitting or counseling visit?

No. It identifies the diaphragm supply rather than a counseling or fitting visit.

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

Open CMS sourceHow we calculate rates

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