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.


  • 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)


  • Continued
  • 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


  • Continued
  • 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)