K0455 — Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
HCPCS Level II K-code · short descriptor: “Pump uninterrupted infusion”
- Code system
- HCPCS Level II
- Family
- K — DME MAC temporary codes
- Medicare coverage status
- Special coverage instructions apply
- DMEPOS payment category
- Frequently serviced
- 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.
K0455 Medicare fee schedule (April 2026)
RR — Monthly rental Frequently serviced
Medicare allowable ranges from $320.84 to $483.38 depending on state and rural status.
Former-CBA payment limits: ceiling $377.46 · floor $320.84
| State | Non-rural | Rural |
|---|---|---|
| AK | $452.07 | — |
| AL | $369.64 | — |
| AR | $377.46 | — |
| AZ | $350.32 | — |
| CA | $377.46 | — |
| CO | $377.46 | — |
| CT | $377.46 | — |
| DC | $377.46 | — |
| DE | $320.84 | — |
| FL | $345.54 | — |
| GA | $366.16 | — |
| HI | $483.38 | — |
| IA | $377.46 | — |
| ID | $377.46 | — |
| IL | $377.46 | — |
| IN | $377.46 | — |
| KS | $377.46 | — |
| KY | $377.46 | — |
| LA | $377.46 | — |
| MA | $320.84 | — |
| MD | $367.55 | — |
| ME | $320.84 | — |
| MI | $372.60 | — |
| MN | $377.46 | — |
| MO | $377.46 | — |
| MS | $340.45 | — |
| MT | $342.98 | — |
| NC | $377.46 | — |
| ND | $339.85 | — |
| NE | $377.46 | — |
| NH | $320.84 | — |
| NJ | $320.84 | — |
| NM | $333.66 | — |
| NV | $358.76 | — |
| NY | $320.84 | — |
| OH | $377.46 | — |
| OK | $377.46 | — |
| OR | $377.46 | — |
| PA | $320.84 | — |
| PR | $442.67 | — |
| RI | $329.59 | — |
| SC | $377.46 | — |
| SD | $370.18 | — |
| TN | $377.46 | — |
| TX | $377.46 | — |
| UT | $377.46 | — |
| VA | $320.84 | — |
| VI | $377.46 | — |
| VT | $320.84 | — |
| WA | $377.46 | — |
| WI | $377.46 | — |
| WV | $354.96 | — |
| WY | $369.04 | — |
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 K-codes
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