A4311 — Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
HCPCS Level II A-code · short descriptor: “Catheter w/o bag 2-way latex”
- Code system
- HCPCS Level II
- Family
- A — Medical & surgical supplies, ambulance
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Ostomy, tracheostomy & urological supplies
- Prior authorization
- Not on Medicare required-PA list
- Status
- Active (April 2026 HCPCS)
Prior authorization
Not on the Medicare required-PA list as of the January 13, 2026 update (74 items). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.
A4311 Medicare fee schedule (April 2026)
Base (no modifier) Ostomy, tracheostomy & urological supplies
Medicare allowable ranges from $16.05 to $28.00 depending on state and rural status.
Former-CBA payment limits: ceiling $21.11 · floor $17.94
| State | Non-rural | Rural |
|---|---|---|
| AK | $26.22 | — |
| AL | $21.11 | — |
| AR | $21.11 | — |
| AZ | $20.90 | — |
| CA | $21.11 | — |
| CO | $18.71 | — |
| CT | $19.83 | — |
| DC | $17.94 | — |
| DE | $17.94 | — |
| FL | $17.94 | — |
| GA | $21.11 | — |
| HI | $28.00 | — |
| IA | $17.94 | — |
| ID | $17.94 | — |
| IL | $21.11 | — |
| IN | $21.11 | — |
| KS | $17.94 | — |
| KY | $21.11 | — |
| LA | $21.11 | — |
| MA | $19.91 | — |
| MD | $17.94 | — |
| ME | $19.91 | — |
| MI | $21.11 | — |
| MN | $21.11 | — |
| MO | $17.94 | — |
| MS | $21.11 | — |
| MT | $21.11 | — |
| NC | $21.11 | — |
| ND | $21.11 | — |
| NE | $18.30 | — |
| NH | $18.96 | — |
| NJ | $17.94 | — |
| NM | $21.11 | — |
| NV | $21.11 | — |
| NY | $19.29 | — |
| OH | $21.11 | — |
| OK | $21.11 | — |
| OR | $17.94 | — |
| PA | $17.94 | — |
| PR | $16.05 | — |
| RI | $17.94 | — |
| SC | $21.11 | — |
| SD | $21.11 | — |
| TN | $20.33 | — |
| TX | $18.33 | — |
| UT | $21.11 | — |
| VA | $17.94 | — |
| VI | $19.29 | — |
| VT | $19.71 | — |
| WA | $21.11 | — |
| WI | $21.11 | — |
| WV | $21.11 | — |
| WY | $21.11 | — |
Amounts are the Medicare DMEPOS fee-schedule allowables effective April 2026.
Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%.
A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area
adjustments and non-continental rates can differ — verify with your DME MAC.
Common denial codes to watch
Related A-codes
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