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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• A4424

  Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each

• A4425

  Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each

• A4426

  Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each

• A4427

  Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each

• A4428

  Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each

• A4429

  Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each

• A4430

  Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each

• A4431

  Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each

• A4432

  Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each

• A4433

  Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each

• A4434

  Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each

• A4435

  Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each

• A4436

  Irrigation supply; sleeve, reusable, per month

• A4437

  Irrigation supply; sleeve, disposable, per month

• A4438

  Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each

• A4450

  Tape, non-waterproof, per 18 square inches

• A4452

  Tape, waterproof, per 18 square inches

• A4453

  Rectal catheter with or without balloon, for use with any type transanal irrigation system, each

• 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 transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type

• A4461

  Surgical dressing holder, non-reusable, each

• A4463

  Surgical dressing holder, reusable, each

• 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

• A4468

  Exsufflation belt, includes all supplies and accessories

• A4470

  Gravlee jet washer

• A4479

  Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type

• A4480

  Vabra aspirator

• A4481

  Tracheostoma filter, any type, any size, each

• A4483

  Moisture exchanger, disposable, for use with invasive mechanical ventilation

• A4490

  Surgical stockings above knee length, each

• A4495

  Surgical stockings thigh length, each

• A4500

  Surgical stockings below knee length, each

• A4510

  Surgical stockings full length, each

• A4520

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

• A4540

  Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm

• A4541

  Monthly supplies for use of device coded at e0733

• A4542

  Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist

• A4543

  Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month

• A4544

  Electrode for external lower extremity nerve stimulator for restless legs syndrome

• A4545

  Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month

• A4550

  Surgical trays

• A4553

  Non-disposable underpads, all sizes

• A4554

  Disposable underpads, all sizes

• A4555

  Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only

• A4556

  Electrodes, (e.g., apnea monitor), per pair

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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 6/3/2026

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