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

CMS doesn’t publish an office rate for A4266 in Florida.

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

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 in Florida

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

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.

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.

A4266 compared with similar codes

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.

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