A4223 — Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
A4223 is a HCPCS Level II code for infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately). 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 A4223 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.
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
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 A4223
- Long descriptor
- Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately)
- Short descriptor
- Infusion supplies w/o pump
- Added
- January 1, 2005
- 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 A4223
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4223 is not quite right, the correct code is very often within a few positions of it.
- 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
- A4220Refill kit for implantable infusion pump
- A4221Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)
- A4222Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)
- A4224Supplies for maintenance of insulin infusion catheter, per week
- A4225Supplies for external insulin infusion pump, syringe type cartridge, sterile, each
- A4226Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week
- A4230Infusion set for external insulin pump, non needle cannula type
- A4231Infusion set for external insulin pump, needle type
- A4232Syringe with needle for external insulin pump, sterile, 3 cc
- A4233Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each
- A4234Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each
Questions about A4223
What is HCPCS code A4223?
A4223 is a HCPCS Level II code for infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately). It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4223?
The CMS HCPCS file marks A4223 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 A4223 paid under the physician fee schedule?
A4223 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.