HCPCS code A4267: Male condom, each2026 Medicare rate & RVUs in Florida
A single male condom furnished as a contraceptive supply; this HCPCS code is not valid for Medicare and is not payable.
CMS doesn’t publish an office rate for A4267 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.
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On this page 9 sections
What A4267 covers
This code identifies an individual male condom furnished as a contraceptive supply. Pharmacies, family planning clinics, and other suppliers may provide condoms for use as a barrier method of contraception. The code distinguishes this product from female condoms and other contraceptive supplies such as diaphragms and cervical caps.
A4267 has Medicare physician fee schedule status I, meaning it is not valid for Medicare and Medicare uses a different code to report and pay for the service. The A4267 code itself is not payable by Medicare and is not separately priced under Medicare Part B. One unit represents one condom, not a package quantity. It should not be submitted as a payable Medicare line.
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 A4267 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.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | Unavailable |
| Miami, FL | Unavailable | Unavailable |
| Rest of Florida | Unavailable | Unavailable |
How the A4267 rate is calculated
Each of A4267’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 · A4267
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 A4267
A4267 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 · A4267
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
—
A4267 isn’t priced in this setting.
A4267 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- A4268Female condomPer condom
- Use A4267 for a male condom and A4268 for a female condom. They identify different products, even though both are barrier contraceptives.
- A4266DiaphragmContraceptive use
- A4266 identifies a diaphragm, not a condom. Select A4267 only when the supplied item is a male condom.
- A4261Cervical capContraceptive use
- A4261 identifies a cervical cap. A4267 is specific to a male condom.
A4267 billing questions
What does one unit represent?
One unit represents one male condom, rather than a box or package.
Can A4267 be billed to Medicare as a payable line?
No. A4267 is not valid for Medicare and is not payable; Medicare uses a different code to report and pay for the service.
How is this different from A4268?
A4267 identifies a male condom. A4268 identifies a female condom, a different barrier contraceptive product.
Should a diaphragm or cervical cap be reported as A4267?
No. A4266 identifies a diaphragm, and A4261 identifies a cervical cap; A4267 is for a male condom.
Does A4267 represent a package of condoms?
No. The unit is each individual condom, not a box or other package quantity.
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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