A5105 — Urinary suspensory with leg bag, with or without tube, each
HCPCS Level II A-code · short descriptor: “Urinary suspensory”
- 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.
A5105 Medicare fee schedule (April 2026)
Base (no modifier) Ostomy, tracheostomy & urological supplies
Medicare allowable ranges from $28.84 to $91.13 depending on state and rural status.
Former-CBA payment limits: ceiling $58.11 · floor $49.39
| State | Non-rural | Rural |
|---|---|---|
| AK | $85.21 | — |
| AL | $49.39 | — |
| AR | $54.50 | — |
| AZ | $58.11 | — |
| CA | $58.11 | — |
| CO | $51.40 | — |
| CT | $58.11 | — |
| DC | $58.11 | — |
| DE | $58.11 | — |
| FL | $49.39 | — |
| GA | $58.11 | — |
| HI | $91.13 | — |
| IA | $58.11 | — |
| ID | $58.11 | — |
| IL | $58.11 | — |
| IN | $58.11 | — |
| KS | $49.39 | — |
| KY | $50.60 | — |
| LA | $56.00 | — |
| MA | $49.39 | — |
| MD | $58.11 | — |
| ME | $49.39 | — |
| MI | $58.11 | — |
| MN | $58.11 | — |
| MO | $55.20 | — |
| MS | $58.11 | — |
| MT | $56.08 | — |
| NC | $58.11 | — |
| ND | $57.79 | — |
| NE | $49.39 | — |
| NH | $49.39 | — |
| NJ | $58.11 | — |
| NM | $54.50 | — |
| NV | $58.11 | — |
| NY | $58.11 | — |
| OH | $58.11 | — |
| OK | $54.50 | — |
| OR | $49.39 | — |
| PA | $58.11 | — |
| PR | $28.84 | — |
| RI | $58.11 | — |
| SC | $49.39 | — |
| SD | $55.34 | — |
| TN | $58.11 | — |
| TX | $58.11 | — |
| UT | $52.87 | — |
| VA | $49.39 | — |
| VI | $58.11 | — |
| VT | $49.39 | — |
| WA | $58.11 | — |
| WI | $58.11 | — |
| WV | $58.11 | — |
| WY | $57.79 | — |
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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