A4312 — Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
A4312 is a HCPCS Level II code for insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 statusP
Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.
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 A4312 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
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 3 units MAI 3 — Date of Service Edit: Clinical · Published Contractor 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 A4312
- Long descriptor
- Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone
- Short descriptor
- Cath w/o bag 2-way silicone
- Added
- January 1, 1990
- BETOS
- D1F
- Pricing indicator
- 37 — DMEPOS
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.
Ostomy, tracheostomy and urological supplies. Price subject to floors and ceilings.
Codes adjacent to A4312
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4312 is not quite right, the correct code is very often within a few positions of it.
- A4296Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each
- A4297Intermittent urinary catheter; hydrophilic coating, with insertion supplies
- A4300Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
- A4301Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)
- A4305Disposable drug delivery system, flow rate of 50 ml or greater per hour
- A4306Disposable drug delivery system, flow rate of less than 50 ml per hour
- A4310Insertion tray without drainage bag and without catheter (accessories only)
- A4311Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
- A4313Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
- A4314Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)
- A4315Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone
- A4316Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation
- A4318Female external urinary collection cup, with or without ring attachment, per day
- A4320Irrigation tray with bulb or piston syringe, any purpose
- A4321Therapeutic agent for urinary catheter irrigation
- A4322Irrigation syringe, bulb or piston, each
Questions about A4312
What is HCPCS code A4312?
A4312 is a HCPCS Level II code for insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4312?
The CMS HCPCS file marks A4312 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A4312 paid under the physician fee schedule?
A4312 carries PFS status code P. Bundled or excluded. No RVUs and no payment: either bundled into another service or paid under a different provision of the Act.