A4209 — Syringe with needle, sterile 5 cc or greater, each
A4209 is a HCPCS Level II code for syringe with needle, sterile 5 cc or greater, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4209 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 6 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4209
- Long descriptor
- Syringe with needle, sterile 5 cc or greater, each
- Short descriptor
- 5+ cc sterile syringe&needle
- Added
- January 1, 1985
- BETOS
- D1A
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to A4209
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4209 is not quite right, the correct code is very often within a few positions of it.
- A2042Foundation drs+ solo, per square centimeter
- A2043Biobrane, per square centimeter
- A2044Biobrane glove, each
- A2045Novashield or novogen wound matrix, per square centimeter
- A4100Non-sheet form skin substitute, fda cleared as a device, not otherwise specified (list in addition to primary procedure)
- A4206Syringe with needle, sterile, 1 cc or less, each
- A4207Syringe with needle, sterile 2 cc, each
- A4208Syringe with needle, sterile 3 cc, each
- A4210Needle-free injection device, each
- A4211Supplies for self-administered injections
- A4212Non-coring needle or stylet with or without catheter
- A4213Syringe, sterile, 20 cc or greater, each
- A4215Needle, sterile, any size, each
- A4216Sterile water, saline and/or dextrose, diluent/flush, 10 ml
- A4217Sterile water/saline, 500 ml
- A4218Sterile saline or water, metered dose dispenser, 10 ml
Questions about A4209
What is HCPCS code A4209?
A4209 is a HCPCS Level II code for syringe with needle, sterile 5 cc or greater, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4209?
The CMS HCPCS file marks A4209 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4209 paid under the physician fee schedule?
A4209 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.