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 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 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 2026Q3.
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
Questions about A4455
What is HCPCS code A4455?
A4455 is a HCPCS Level II code for adhesive remover or solvent (for tape, cement or other adhesive), per ounce. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4455?
The CMS HCPCS file marks A4455 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 A4455 paid under the physician fee schedule?
A4455 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.