A4320 — Irrigation tray with bulb or piston syringe, any purpose
HCPCS Level II A-code · short descriptor: “Irrigation tray”
- 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.
A4320 Medicare fee schedule (April 2026)
Base (no modifier) Ostomy, tracheostomy & urological supplies
Medicare allowable ranges from $6.34 to $8.42 depending on state and rural status.
Former-CBA payment limits: ceiling $7.61 · floor $6.47
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.34 | — |
| AL | $7.61 | — |
| AR | $7.61 | — |
| AZ | $7.49 | — |
| CA | $6.47 | — |
| CO | $7.52 | — |
| CT | $7.61 | — |
| DC | $7.16 | — |
| DE | $7.16 | — |
| FL | $7.61 | — |
| GA | $6.72 | — |
| HI | $6.79 | — |
| IA | $6.77 | — |
| ID | $7.61 | — |
| IL | $7.09 | — |
| IN | $7.44 | — |
| KS | $7.36 | — |
| KY | $7.61 | — |
| LA | $7.61 | — |
| MA | $7.61 | — |
| MD | $7.61 | — |
| ME | $7.61 | — |
| MI | $7.01 | — |
| MN | $7.61 | — |
| MO | $7.11 | — |
| MS | $6.47 | — |
| MT | $6.73 | — |
| NC | $6.47 | — |
| ND | $7.61 | — |
| NE | $7.36 | — |
| NH | $7.61 | — |
| NJ | $7.16 | — |
| NM | $7.61 | — |
| NV | $7.61 | — |
| NY | $6.96 | — |
| OH | $6.78 | — |
| OK | $7.61 | — |
| OR | $7.61 | — |
| PA | $7.16 | — |
| PR | $8.42 | — |
| RI | $7.61 | — |
| SC | $7.61 | — |
| SD | $7.61 | — |
| TN | $6.52 | — |
| TX | $6.47 | — |
| UT | $7.21 | — |
| VA | $7.61 | — |
| VI | $6.96 | — |
| VT | $7.61 | — |
| WA | $7.61 | — |
| WI | $7.61 | — |
| WV | $6.78 | — |
| WY | $7.61 | — |
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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