HCPCS code A4268: Female condom, per condom2026 Medicare rate & RVUs in Florida
A4268 denotes one female condom supplied for contraception; Medicare assigns it status I and does not accept it as a payable reporting code.
CMS doesn’t publish an office rate for A4268 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 A4268 covers
A4268 represents one female condom, also called an internal condom: a barrier contraceptive product placed inside the vagina for use during intercourse to prevent pregnancy. The code identifies the supply itself, rather than counseling or a contraceptive procedure. Its each-item basis means one unit represents one individual condom supplied.
For Medicare, A4268 has physician fee schedule status I, meaning it is not valid for Medicare reporting and Medicare uses a different code to report and pay for this service. CMS also classifies it as not payable and not separately priced under Medicare Part B. Do not submit A4268 as a payable Medicare line. The item is distinct from the male condom (A4267), diaphragm (A4266), and cervical cap (A4261) supply codes.
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 A4268 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 A4268 rate is calculated
Each of A4268’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 · A4268
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 A4268
A4268 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 · A4268
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
—
A4268 isn’t priced in this setting.
A4268 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- A4267Male condomEach
- Choose A4268 for a female, or internal, condom; A4267 identifies a male condom.
- A4266DiaphragmContraceptive use
- A4266 identifies a diaphragm, not a female condom. The products are different barrier contraceptives.
- A4261Cervical capContraceptive use
- A4261 identifies a cervical cap. A4268 identifies a separate product, the female condom.
A4268 billing questions
What does one unit of A4268 represent?
One unit represents one female condom. The reported quantity corresponds to the number of individual condoms supplied.
How is A4268 different from A4267?
A4268 identifies a female, or internal, condom; A4267 identifies a male condom.
When would A4266 be used instead?
A4266 identifies a diaphragm, a different barrier contraceptive. It is not the code for a female condom.
Can A4268 be billed to Medicare?
No. Medicare assigns A4268 status I and marks it not payable; it is not a valid Medicare reporting code.
What supply does A4268 identify?
It identifies the female condom supply, with each unit representing one individual condom.
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
Fee sheets · Coming soon
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