A4640 — Replacement pad for use with medically necessary alternating pressure pad owned by patient
HCPCS Level II A-code · short descriptor: “Alternating pressure pad”
- Code system
- HCPCS Level II
- Family
- A — Medical & surgical supplies, ambulance
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Inexpensive or routinely purchased
- 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.
A4640 Medicare fee schedule (April 2026)
NU — New purchase Inexpensive or routinely purchased
Medicare allowable ranges from $58.10 to $93.30 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $79.69 | — |
| AL | $63.32 | $81.35 |
| AR | $63.32 | $74.59 |
| AZ | $62.21 | $74.59 |
| CA | $58.10 | $76.48 |
| CO | $66.38 | $81.35 |
| CT | $72.47 | $81.35 |
| DC | $63.45 | $74.59 |
| DE | $63.45 | $74.59 |
| FL | $63.32 | $74.59 |
| GA | $63.32 | $81.35 |
| HI | $82.51 | — |
| IA | $67.23 | $81.35 |
| ID | $66.38 | $74.59 |
| IL | $70.12 | $81.35 |
| IN | $70.12 | $81.35 |
| KS | $67.23 | $81.35 |
| KY | $63.32 | $81.35 |
| LA | $63.32 | $74.59 |
| MA | $72.47 | $81.35 |
| MD | $63.45 | $74.59 |
| ME | $72.47 | $81.35 |
| MI | $70.12 | $79.50 |
| MN | $67.23 | $74.59 |
| MO | $67.23 | $81.35 |
| MS | $63.32 | $74.59 |
| MT | $66.38 | $81.35 |
| NC | $63.32 | $76.90 |
| ND | $67.23 | $81.35 |
| NE | $67.23 | $81.35 |
| NH | $72.47 | $81.35 |
| NJ | $63.45 | $78.85 |
| NM | $62.21 | $81.35 |
| NV | $58.10 | $74.59 |
| NY | $63.45 | $75.87 |
| OH | $70.12 | $74.84 |
| OK | $62.21 | $81.35 |
| OR | $58.10 | $74.59 |
| PA | $63.45 | $74.59 |
| PR | $93.30 | — |
| RI | $72.47 | $81.35 |
| SC | $63.32 | $74.59 |
| SD | $67.23 | $81.35 |
| TN | $63.32 | $77.59 |
| TX | $62.21 | $74.59 |
| UT | $66.38 | $81.35 |
| VA | $63.32 | $81.35 |
| VI | $78.69 | — |
| VT | $72.47 | $81.35 |
| WA | $58.10 | $76.61 |
| WI | $70.12 | $81.35 |
| WV | $63.32 | $74.89 |
| WY | $66.38 | $81.35 |
RR — Monthly rental Inexpensive or routinely purchased
Medicare allowable ranges from $5.81 to $10.69 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $6.88 | — |
| AL | $6.33 | $8.22 |
| AR | $6.33 | $7.78 |
| AZ | $6.22 | $8.22 |
| CA | $5.81 | $7.53 |
| CO | $6.64 | $8.22 |
| CT | $7.25 | $8.22 |
| DC | $6.35 | $7.53 |
| DE | $6.35 | $7.53 |
| FL | $6.33 | $7.53 |
| GA | $6.33 | $8.22 |
| HI | $7.36 | — |
| IA | $6.72 | $8.22 |
| ID | $6.64 | $7.78 |
| IL | $7.01 | $8.22 |
| IN | $7.01 | $8.03 |
| KS | $6.72 | $8.22 |
| KY | $6.33 | $8.22 |
| LA | $6.33 | $7.78 |
| MA | $7.25 | $8.22 |
| MD | $6.35 | $7.53 |
| ME | $7.25 | $8.22 |
| MI | $7.01 | $7.94 |
| MN | $6.72 | $7.53 |
| MO | $6.72 | $8.22 |
| MS | $6.33 | $7.53 |
| MT | $6.64 | $8.22 |
| NC | $6.33 | $7.78 |
| ND | $6.72 | $8.22 |
| NE | $6.72 | $8.22 |
| NH | $7.25 | $8.22 |
| NJ | $6.35 | $7.88 |
| NM | $6.22 | $8.22 |
| NV | $5.81 | $8.22 |
| NY | $6.35 | $7.77 |
| OH | $7.01 | $7.53 |
| OK | $6.22 | $8.22 |
| OR | $5.81 | $7.53 |
| PA | $6.35 | $7.53 |
| PR | $10.69 | — |
| RI | $7.25 | $8.22 |
| SC | $6.33 | $7.53 |
| SD | $6.72 | $8.22 |
| TN | $6.33 | $7.77 |
| TX | $6.22 | $7.53 |
| UT | $6.64 | $8.22 |
| VA | $6.33 | $8.22 |
| VI | $8.05 | — |
| VT | $7.25 | $8.22 |
| WA | $5.81 | $7.65 |
| WI | $7.01 | $7.92 |
| WV | $6.33 | $7.53 |
| WY | $6.64 | $8.22 |
UE — Used purchase Inexpensive or routinely purchased
Medicare allowable ranges from $43.58 to $69.96 depending on state and rural status.
| State | Non-rural | Rural |
|---|---|---|
| AK | $59.79 | — |
| AL | $47.49 | $59.15 |
| AR | $47.49 | $55.90 |
| AZ | $46.66 | $54.35 |
| CA | $43.58 | $57.35 |
| CO | $49.79 | $59.15 |
| CT | $54.35 | $59.15 |
| DC | $47.59 | $54.35 |
| DE | $47.59 | $54.35 |
| FL | $47.49 | $54.41 |
| GA | $47.49 | $59.15 |
| HI | $61.88 | — |
| IA | $50.42 | $58.38 |
| ID | $49.79 | $55.92 |
| IL | $52.59 | $59.15 |
| IN | $52.59 | $59.15 |
| KS | $50.42 | $57.17 |
| KY | $47.49 | $59.15 |
| LA | $47.49 | $55.90 |
| MA | $54.35 | $59.15 |
| MD | $47.59 | $54.35 |
| ME | $54.35 | $59.15 |
| MI | $52.59 | $59.15 |
| MN | $50.42 | $54.35 |
| MO | $50.42 | $59.15 |
| MS | $47.49 | $54.35 |
| MT | $49.79 | $59.15 |
| NC | $47.49 | $55.53 |
| ND | $50.42 | $59.15 |
| NE | $50.42 | $59.15 |
| NH | $54.35 | $59.15 |
| NJ | $47.59 | $59.15 |
| NM | $46.66 | $59.15 |
| NV | $43.58 | $54.35 |
| NY | $47.59 | $55.96 |
| OH | $52.59 | $56.16 |
| OK | $46.66 | $59.15 |
| OR | $43.58 | $54.35 |
| PA | $47.59 | $54.35 |
| PR | $69.96 | — |
| RI | $54.35 | $59.15 |
| SC | $47.49 | $54.35 |
| SD | $50.42 | $59.15 |
| TN | $47.49 | $58.20 |
| TX | $46.66 | $54.35 |
| UT | $49.79 | $59.15 |
| VA | $47.49 | $59.15 |
| VI | $57.57 | — |
| VT | $54.35 | $59.15 |
| WA | $43.58 | $57.47 |
| WI | $52.59 | $59.15 |
| WV | $47.49 | $56.16 |
| WY | $49.79 | $59.15 |
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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