A4455: Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
A4455 is a HCPCS Level II code for adhesive remover or solvent (for tape, cement or other adhesive), per ounce. 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 2026Q4-Oct. 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 A4455 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
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 2026Q4.
The CMS record for A4455
- Long descriptor
- Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
- Short descriptor
- Adhesive remover per ounce
- Added
- January 1, 1989
- 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 A4455
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If A4455 is not quite right, the correct code is very often within a few positions of it.
- A4434Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each
- A4435Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each
- A4436Irrigation supply; sleeve, reusable, per month
- A4437Irrigation supply; sleeve, disposable, per month
- A4438Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each
- A4450Tape, non-waterproof, per 18 square inches
- A4452Tape, waterproof, per 18 square inches
- A4453Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
- A4456Adhesive remover, wipes, any type, each
- A4457Enema tube, with or without adapter, any type, replacement only, each
- A4458Enema bag with tubing, reusable
- A4459Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
- A4461Surgical dressing holder, non-reusable, each
- A4463Surgical dressing holder, reusable, each
- A4465Non-elastic binder for extremity
- A4466Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, eachterminated