This section covers a wide variety of medical and surgical supplies, as well as some DME-related supplies and accessories. Medicare generally covers DME-related supplies, accessories, maintenance, and repair under the prosthetic devices provision.

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• A2011

  Supra sdrm, per square centimeter (add-on, list separately in addition to primary procedure)

• A2012

  Suprathel, per square centimeter (add-on, list separately in addition to primary procedure)

• A2013

  Innovamatrix fs, per square centimeter (add-on, list separately in addition to primary procedure)

• A2014

  Omeza collagen matrix or omeza complete matrix, per 100 mg

• A2015

  Phoenix wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)

• A2016

  Permeaderm b, per square centimeter (add-on, list separately in addition to primary procedure)

• A2017

  Permeaderm glove, each

• A2018

  Permeaderm c, per square centimeter (add-on, list separately in addition to primary procedure)

• A2019

  Kerecis omega3 marigen shield, per square centimeter (add-on, list separately in addition to primary procedure)

• A2020

  Ac5 advanced wound system (ac5)

• A2021

  Neomatrix, per square centimeter (add-on, list separately in addition to primary procedure)

• A2022

  Innovaburn or innovamatrix xl, per square centimeter (add-on, list separately in addition to primary procedure)

• A2023

  Innovamatrix pd, 1 mg

• A2024

  Resolve matrix or xenopatch, per square centimeter (add-on, list separately in addition to primary procedure)

• A2025

  Miro3d, per cubic centimeter (add-on, list separately in addition to primary procedure)

• A2026

  Restrata minimatrix, 5 mg

• A2027

  Matriderm, per square centimeter (add-on, list separately in addition to primary procedure)

• A2028

  Micromatrix flex, per mg

• A2029

  Mirotract wound matrix sheet, per cubic centimeter (add-on, list separately in addition to primary procedure)

• A2030

  Miro3d fibers, per milligram

• A2031

  Mirodry wound matrix, per square centimeter (add-on, list separately in addition to primary procedure)

• A2032

  Myriad matrix, per square centimeter (add-on, list separately in addition to primary procedure)

• A2033

  Myriad morcells, 4 milligrams

• A2034

  Foundation drs solo, per square centimeter (add-on, list separately in addition to primary procedure)

• A2035

  Corplex p or theracor p or allacor p, per milligram

• A2036

  Cohealyx collagen dermal matrix, per square centimeter (add-on, list separately in addition to primary procedure)

• A2037

  G4derm plus/suprello, per milliliter

• A2038

  Marigen pacto, per square centimeter (add-on, list separately in addition to primary procedure)

• A2039

  Innovamatrix fd, per square centimeter (add-on, list separately in addition to primary procedure)

• A2040

  Microlyte painguard, per square centimeter

• A2041

  Foundation drs+ duo, per square centimeter

• A2042

  Foundation drs+ solo, per square centimeter

• A2043

  Biobrane, per square centimeter

• A2044

  Biobrane glove, each

• A2045

  Novashield or novogen wound matrix, per square centimeter

• A4100

  Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)

• A4206

  Syringe with needle, sterile, 1 cc or less, each

• A4207

  Syringe with needle, sterile 2 cc, each

• A4208

  Syringe with needle, sterile 3 cc, each

• A4209

  Syringe with needle, sterile 5 cc or greater, each

• 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

• A4216

  Sterile water, saline and/or dextrose, diluent/flush, 10 ml

• A4217

  Sterile water/saline, 500 ml

• A4218

  Sterile saline or water, metered dose dispenser, 10 ml

• A4220

  Refill kit for implantable infusion pump

• A4221

  Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)

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HCPCS Level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). — Updated 7/24/2026

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