# HCPCS A7028: Repl oral cushion combo mask

Medicare HCPCS A7028 pays $43.57 on average under the 2026 Q4 Medicare DMEPOS Fee Schedule (non-rural, NU · purchase, new). State amounts run from $40.30 in Pennsylvania to $66.05 in Puerto Rico, a 64% spread.

Web page: https://www.med-reveal.com/rates/A7028-hcpcs-fee-schedule
Section: DME, Prosthetics, Orthotics and Supplies
Billed by: Sleep Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $43.57 |
| National facility | $43.57 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Puerto Rico | $66.05 | $66.05 |
| Alaska | $58.99 | $58.99 |
| Hawaii | $58.99 | $58.99 |
| Virgin Islands | $58.99 | $58.99 |
| Iowa | $43.48 | $43.48 |
| Kansas | $43.48 | $43.48 |
| Minnesota | $43.48 | $43.48 |
| Missouri | $43.48 | $43.48 |
| Nebraska | $43.48 | $43.48 |
| North Dakota | $43.48 | $43.48 |
| South Dakota | $43.48 | $43.48 |
| Illinois | $43.27 | $43.27 |
| Indiana | $43.27 | $43.27 |
| Michigan | $43.27 | $43.27 |
| Ohio | $43.27 | $43.27 |
| Wisconsin | $43.27 | $43.27 |
| Alabama | $42.97 | $42.97 |
| Arkansas | $42.97 | $42.97 |
| Florida | $42.97 | $42.97 |
| Georgia | $42.97 | $42.97 |
| Kentucky | $42.97 | $42.97 |
| Louisiana | $42.97 | $42.97 |
| Mississippi | $42.97 | $42.97 |
| North Carolina | $42.97 | $42.97 |
| South Carolina | $42.97 | $42.97 |
| Tennessee | $42.97 | $42.97 |
| Virginia | $42.97 | $42.97 |
| West Virginia | $42.97 | $42.97 |
| California | $41.72 | $41.72 |
| Nevada | $41.72 | $41.72 |
| Oregon | $41.72 | $41.72 |
| Washington | $41.72 | $41.72 |
| Colorado | $41.64 | $41.64 |
| Idaho | $41.64 | $41.64 |
| Montana | $41.64 | $41.64 |
| Utah | $41.64 | $41.64 |
| Wyoming | $41.64 | $41.64 |
| Connecticut | $41.59 | $41.59 |
| Maine | $41.59 | $41.59 |
| Massachusetts | $41.59 | $41.59 |
| New Hampshire | $41.59 | $41.59 |
| Rhode Island | $41.59 | $41.59 |
| Vermont | $41.59 | $41.59 |
| Arizona | $40.86 | $40.86 |
| New Mexico | $40.86 | $40.86 |
| Oklahoma | $40.86 | $40.86 |
| Texas | $40.86 | $40.86 |
| Delaware | $40.30 | $40.30 |
| District of Columbia | $40.30 | $40.30 |
| Maryland | $40.30 | $40.30 |
| New Jersey | $40.30 | $40.30 |
| New York | $40.30 | $40.30 |
| Pennsylvania | $40.30 | $40.30 |

## Related codes

- A7027: Combination oral/nasal mask — https://www.med-reveal.com/rates/A7027-hcpcs-fee-schedule
- A7029: Repl nasal pillow comb mask — https://www.med-reveal.com/rates/A7029-hcpcs-fee-schedule
- A7030: Cpap full face mask — https://www.med-reveal.com/rates/A7030-hcpcs-fee-schedule
- A7031: Replacement facemask interfa — https://www.med-reveal.com/rates/A7031-hcpcs-fee-schedule
- A7032: Replacement nasal cushion — https://www.med-reveal.com/rates/A7032-hcpcs-fee-schedule
- A7033: Replacement nasal pillows — https://www.med-reveal.com/rates/A7033-hcpcs-fee-schedule

Commercial negotiated rates for A7028 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules