HCPCS code A4269: Spermicide, each supply2026 Medicare rate & RVUs in Texas

CMS doesn’t publish an office rate for A4269 in Texas.

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

What A4269 covers

A4269 identifies a spermicide product supplied for contraception, including foam and gel forms. It represents the supply rather than a counseling service or procedure. A supplier or clinician may report the item when furnishing spermicide; it can be used alone or with a diaphragm or cervical cap. The spermicide and the barrier device are distinct supplies: A4266 identifies a diaphragm, and A4261 identifies a cervical cap.

Medicare treats A4269 as status I: it is not a valid Medicare code, and Medicare uses a different code to report and pay for this service. Its HCPCS pricing designation says it is not separately priced by Medicare Part B, and its coverage designation says it is not payable by Medicare. The reporting unit is each spermicide supply item. A4266 and A4261 identify the barrier devices, while A4269 identifies the spermicide supply.

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 A4269 pays more and less in Texas

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

8 of 8 payment localities

How the A4269 rate is calculated

Each of A4269’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 A4269

A4269 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.

A4269 compared with similar codes

How to choose

A4266DiaphragmContraceptive use

A4266 identifies a diaphragm; A4269 identifies the spermicide supply that may be used with it.

A4261Cervical capContraceptive use

A4261 identifies a cervical cap. Use A4269 for the spermicide supply, not for the cap itself.

A4267Male condomEach

A4267 identifies a male condom, while A4269 identifies spermicide; they are different contraceptive supplies.

A4268Female condomPer condom

A4268 identifies a female condom, while A4269 identifies spermicide; they are different contraceptive supplies.

Codes related to A4269

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