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A4463 — Surgical dressing holder, reusable, each

HCPCS Level II A-code · short descriptor: “Surgical dress holder reuse”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
Surgical dressings
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.

A4463 Medicare fee schedule (April 2026)

Base (no modifier) Surgical dressings

Medicare allowable ranges from $18.97 to $20.88 depending on state and rural status.

Former-CBA payment limits: ceiling $18.97 · floor $16.12

StateNon-ruralRural
AK$18.97
AL$18.97
AR$18.97
AZ$18.97
CA$18.97
CO$18.97
CT$18.97
DC$18.97
DE$18.97
FL$18.97
GA$18.97
HI$18.97
IA$18.97
ID$18.97
IL$18.97
IN$18.97
KS$18.97
KY$18.97
LA$18.97
MA$18.97
MD$18.97
ME$18.97
MI$18.97
MN$18.97
MO$18.97
MS$18.97
MT$18.97
NC$18.97
ND$18.97
NE$18.97
NH$18.97
NJ$18.97
NM$18.97
NV$18.97
NY$18.97
OH$18.97
OK$18.97
OR$18.97
PA$18.97
PR$20.88
RI$18.97
SC$18.97
SD$18.97
TN$18.97
TX$18.97
UT$18.97
VA$18.97
VI$18.97
VT$18.97
WA$18.97
WI$18.97
WV$18.97
WY$18.97
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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