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HCPCS Procedure & Supply Codes
Medical And Surgical Supplies
section notes
Miscellaneous Medical and Surgical Supplies
section notes
A4206A4209   Syringe with needle, sterile
A4210   Needle-free injection device, each
A4211   Supplies for self-administered injections
A4212   Non-coring needle or stylet with or without catheter
A4213   Syringe, sterile, 20 cc or greater, each
A4215   Needle, sterile, any size, each
A4216A4218   Sterile water/saline
A4220   Refill kit for implantable infusion pump
A4221   Supplies for maintenance of non-insulin drug infusion catheter, per week (list d...
A4222   Infusion supplies for external drug infusion pump, per cassette or bag (list dru...
A4223   Infusion supplies not used with external infusion pump, per cassette or bag (lis...
A4224   Supplies for maintenance of insulin infusion catheter, per week
A4225   Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
A4226   Supplies for maintenance of insulin infusion pump with dosage rate adjustment us...
A4230   Infusion set for external insulin pump, non needle cannula type
A4231   Infusion set for external insulin pump, needle type
A4232   Syringe with needle for external insulin pump, sterile, 3 cc
A4233A4236   Replacement Battery, Home Blood Glucose Monitor
A4238A4239   Supply Allowance for Non-implanted Continuous Glucose Monitor (CGM)
A4244   Alcohol or peroxide, per pint
A4245   Alcohol wipes, per box
A4246   Betadine or phisohex solution, per pint
A4247   Betadine or iodine swabs/wipes, per box
A4248   Chlorhexidine containing antiseptic, 1 ml
A4250   Urine test or reagent strips or tablets (100 tablets or strips)
A4252   Blood ketone test or reagent strip, each
A4253   Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips
A4255   Platforms for home blood glucose monitor, 50 per box
A4256   Normal, low and high calibrator solution / chips
A4257   Replacement lens shield cartridge for use with laser skin piercing device, each
A4258   Spring-powered device for lancet, each
A4259   Lancets, per box of 100
A4261A4269   Contraceptive supplies
A4262   Temporary, absorbable lacrimal duct implant, each
A4263   Permanent, long term, non-dissolvable lacrimal duct implant, each
A4265   Paraffin, per pound
A4270   Disposable endoscope sheath, each
A4271   Integrated lancing and blood sample testing cartridges for home blood glucose mo...
A4280A4287   Breast pump accessories
A4290A4596   Electrical and/or Stimulator Supplies
A4450   Tape, non-waterproof, per 18 square inches
A4452   Tape, waterproof, per 18 square inches
A4455   Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
A4456   Adhesive remover, wipes, any type, each
A4457   Enema tube, with or without adapter, any type, replacement only, each
A4458   Enema bag with tubing, reusable
A4459   Manual pump-operated enema system, includes balloon, catheter and all accessorie...
A4461   Surgical dressing holder, non-reusable, each
A4463   Surgical dressing holder, reusable, each
A4465   Non-elastic binder for extremity
A4467   Belt, strap, sleeve, garment, or covering, any type
A4468   Exsufflation belt, includes all supplies and accessories
A4470   Gravlee jet washer
A4480   Vabra aspirator
A4481   Tracheostoma filter, any type, any size, each
A4483   Moisture exchanger, disposable, for use with invasive mechanical ventilation
A4490A4510   Surgical stockings, each
A4520   Incontinence garment, any type, (e.g., brief, diaper), each
A4541   Monthly supplies for use of device coded at e0733
A4550   Surgical trays
A4554   Disposable underpads, all sizes
A4559   Coupling gel or paste, for use with ultrasound device, per oz
A4561A4564   Pessary, any type
A4565   Slings
A4566   Shoulder sling or vest design, abduction restrainer, with or without swathe cont...
A4570   Splint
A4575   Topical hyperbaric oxygen chamber, disposable
A4580   Cast supplies (e.g., plaster)
A4590   Special casting material (e.g., fiberglass)
A4600   Sleeve for intermittent limb compression device, replacement only, each
A7021   Supplies and accessories for lung expansion airway clearance, continuous high fr...
A8000A8003   Helmet, protective, includes all components and accessories
A8004   Soft interface for helmet, replacement only
A9273   Cold or hot fluid bottle, ice cap or collar, heat and/or cold wrap, any type
A9285   Inversion/eversion correction device
A9286   Hygienic item or device, disposable or non-disposable, any type, each
A9293   Fertility cycle (contraception & conception) tracking software application, fda ...
A9506   Graphite crucible for preparation of technetium tc 99m-labeled carbon aerosol, o...
A9574   Air polymer-type a intrauterine foam, 0.1 ml
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