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A7033 — Pillow for use on nasal cannula type interface, replacement only, pair

HCPCS Level II A-code · short descriptor: “Replacement nasal pillows”

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
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.

A7033 Medicare fee schedule (April 2026)

NU — New purchase Inexpensive or routinely purchased

Medicare allowable ranges from $19.26 to $31.66 depending on state and rural status.

StateNon-ruralRural
AK$28.18
AL$19.36$28.25
AR$19.36$28.25
AZ$19.37$28.25
CA$19.48$28.25
CO$19.66$28.25
CT$20.06$28.25
DC$19.26$28.25
DE$19.26$28.25
FL$19.36$28.25
GA$19.36$28.25
HI$28.18
IA$19.55$28.25
ID$19.66$28.25
IL$19.42$28.25
IN$19.42$28.25
KS$19.55$28.25
KY$19.36$28.25
LA$19.36$28.25
MA$20.06$28.25
MD$19.26$28.25
ME$20.06$28.25
MI$19.42$28.25
MN$19.55$28.25
MO$19.55$28.25
MS$19.36$28.25
MT$19.66$28.25
NC$19.36$28.25
ND$19.55$28.25
NE$19.55$28.25
NH$20.06$28.25
NJ$19.26$28.25
NM$19.37$28.25
NV$19.48$28.25
NY$19.26$28.25
OH$19.42$28.25
OK$19.37$28.25
OR$19.48$28.25
PA$19.26$28.25
PR$31.66
RI$20.06$28.25
SC$19.36$28.25
SD$19.55$28.25
TN$19.36$28.25
TX$19.37$28.25
UT$19.66$28.25
VA$19.36$28.25
VI$28.18
VT$20.06$28.25
WA$19.48$28.25
WI$19.42$28.25
WV$19.36$28.25
WY$19.66$28.25
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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