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A4357 — Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each

HCPCS Level II A-code · short descriptor: “Bedside drainage bag”

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.

A4357 Medicare fee schedule (April 2026)

Base (no modifier) Ostomy, tracheostomy & urological supplies

Medicare allowable ranges from $11.76 to $15.39 depending on state and rural status.

Former-CBA payment limits: ceiling $13.84 · floor $11.76

StateNon-ruralRural
AK$14.40
AL$13.84
AR$13.84
AZ$13.77
CA$13.84
CO$13.84
CT$13.30
DC$13.11
DE$13.11
FL$13.84
GA$11.76
HI$15.39
IA$13.01
ID$11.76
IL$13.84
IN$13.84
KS$13.61
KY$11.76
LA$13.84
MA$11.76
MD$13.84
ME$11.76
MI$13.84
MN$13.84
MO$13.84
MS$11.76
MT$11.76
NC$13.84
ND$13.84
NE$13.52
NH$13.84
NJ$13.11
NM$11.76
NV$13.84
NY$13.84
OH$13.84
OK$11.76
OR$13.84
PA$13.11
PR$13.96
RI$11.76
SC$13.84
SD$13.84
TN$11.76
TX$11.76
UT$11.76
VA$12.26
VI$13.84
VT$11.76
WA$13.84
WI$13.84
WV$13.84
WY$13.84
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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