A4356 — External urethral clamp or compression device (not to be used for catheter clamp), each
HCPCS Level II A-code · short descriptor: “Ext ureth clmp or compr dvc”
- 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.
A4356 Medicare fee schedule (April 2026)
Base (no modifier) Ostomy, tracheostomy & urological supplies
Medicare allowable ranges from $46.97 to $79.51 depending on state and rural status.
Former-CBA payment limits: ceiling $65.03 · floor $55.28
| State | Non-rural | Rural |
|---|---|---|
| AK | $74.39 | — |
| AL | $65.03 | — |
| AR | $65.03 | — |
| AZ | $61.00 | — |
| CA | $65.03 | — |
| CO | $55.28 | — |
| CT | $65.03 | — |
| DC | $65.03 | — |
| DE | $65.03 | — |
| FL | $65.03 | — |
| GA | $65.03 | — |
| HI | $79.51 | — |
| IA | $61.76 | — |
| ID | $55.28 | — |
| IL | $65.03 | — |
| IN | $65.03 | — |
| KS | $64.36 | — |
| KY | $65.03 | — |
| LA | $65.03 | — |
| MA | $55.28 | — |
| MD | $63.71 | — |
| ME | $55.28 | — |
| MI | $65.03 | — |
| MN | $65.03 | — |
| MO | $65.03 | — |
| MS | $59.30 | — |
| MT | $61.76 | — |
| NC | $64.65 | — |
| ND | $65.03 | — |
| NE | $62.34 | — |
| NH | $55.28 | — |
| NJ | $65.03 | — |
| NM | $65.03 | — |
| NV | $56.08 | — |
| NY | $55.28 | — |
| OH | $65.03 | — |
| OK | $55.28 | — |
| OR | $60.48 | — |
| PA | $65.03 | — |
| PR | $46.97 | — |
| RI | $55.28 | — |
| SC | $60.05 | — |
| SD | $65.03 | — |
| TN | $65.03 | — |
| TX | $55.28 | — |
| UT | $65.03 | — |
| VA | $55.28 | — |
| VI | $55.28 | — |
| VT | $55.28 | — |
| WA | $55.28 | — |
| WI | $65.03 | — |
| WV | $65.03 | — |
| WY | $55.28 | — |
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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