HCPCS Codes for Other medical items or services


  • A4250

    Urine test or reagent strips or tablets (100 tablets or strips)
  • A4261

    Cervical cap for contraceptive use
  • A4262

    Temporary, absorbable lacrimal duct implant, each
  • A4263

    Permanent, long term, non-dissolvable lacrimal duct implant, each
  • A4264

    Permanent implantable contraceptive intratubal occlusion device(s) and delivery system
  • A4265

    Paraffin, per pound
  • A4266

    Diaphragm for contraceptive use
  • A4267

    Contraceptive supply, condom, male, each
  • A4268

    Contraceptive supply, condom, female, each
  • A4269

    Contraceptive supply, spermicide (e.g., foam, gel), each
  • A4270

    Disposable endoscope sheath, each
  • A4281

    Tubing for breast pump, replacement
  • A4282

    Adapter for breast pump, replacement
  • A4283

    Cap for breast pump bottle, replacement
  • A4284

    Breast shield and splash protector for use with breast pump, replacement
  • A4285

    Polycarbonate bottle for use with breast pump, replacement
  • A4286

    Locking ring for breast pump, replacement
  • A4290

    Sacral nerve stimulation test lead, each
  • A4305

    Disposable drug delivery system, flow rate of 50 ml or greater per hour
  • A4306

    Disposable drug delivery system, flow rate of less than 50 ml per hour
  • A4360

    Disposable external urethral clamp or compression device, with pad and/or pouch, each
  • A4458

    Enema bag with tubing, reusable
  • A4459

    Manual pump-operated enema system, includes balloon, catheter and all accessories, reusable, any type
  • A4465

    Non-elastic binder for extremity
  • A4466

    Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each
  • A4467

    Belt, strap, sleeve, garment, or covering, any type
  • A4520

    Incontinence garment, any type, (e.g., brief, diaper), each
  • A4550

    Surgical trays
  • A4553

    Non-disposable underpads, all sizes
  • A4554

    Disposable underpads, all sizes
  • A4566

    Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment
  • A4575

    Topical hyperbaric oxygen chamber, disposable
  • A4580

    Cast supplies (e.g., plaster)
  • A4590

    Special casting material (e.g., fiberglass)
  • A4606

    Oxygen probe for use with oximeter device, replacement
  • A4614

    Peak expiratory flow rate meter, hand held
  • A4627

    Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler
  • A4634

    Replacement bulb for therapeutic light box, tabletop model
  • A4648

    Tissue marker, implantable, any type, each
  • A4649

    Surgical supply; miscellaneous
  • A4650

    Implantable radiation dosimeter, each
  • A4932

    Rectal thermometer, reusable, any type, each
  • A6025

    Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each
  • A9150

    Non-prescription drugs
  • A9152

    Single vitamin/mineral/trace element, oral, per dose, not otherwise specified
  • A9153

    Multiple vitamins, with or without minerals and trace elements, oral, per dose, not otherwise specified
  • A9155

    Artificial saliva, 30 ml
  • A9180

    Pediculosis (lice infestation) treatment, topical, for administration by patient/caretaker
  • A9270

    Non-covered item or service
  • A9272

    Wound suction, disposable, includes dressing, all accessories and components, any type, each