HCPCS Code A4721

Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Code effective Jan 01, 2015

HCPCS Section
Transportation Services Including Ambulance, Medical & Surgical Supplies

A4721 is a valid 2026 HCPCS code meaning Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis or (Dialysat sol fld vol > 999cc) for short. HCPCS A4721 has been effective since 01/01/2015 and applies to ESRD supplies.

HCPCS Code Details - A4721

HCPCS Level II Code
Section A - Transportation Services Including Ambulance, Medical & Surgical Supplies
HCPCS Code A4721
Description

Long description:
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis

Short description:
Dialysat sol fld vol > 999cc

HCPCS Pricing indicator 00 - Physician Fee Schedule And Non-Physician Practitioners - Service not separately priced by part B (e.g., services not covered, bundled, used by Part A only, etc.)
Multiple pricing indicator 9 - Not applicable as HCPCS not priced separately by part B or value is not established
Coverage code D - Special coverage instructions apply
BETOS2 code P9B - Dialysis services (non-medicare fee schedule)
HCPCS Action code N - No maintenance for this code
Type of service L - ESRD supplies
Effective date Effective Jan 01, 2015
Date added Added Jan 01, 2002

See also

  • HCPCS A4720 · Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis

  • HCPCS A4722 · Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis

  • HCPCS A4723 · Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis

  • HCPCS A4724 · Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis

  • HCPCS A4725 · Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

  • HCPCS A4726 · Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis

1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”

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 6/23/2026

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