A4490 — Surgical stockings above knee length, each
A4490 is a HCPCS Level II code for surgical stockings above knee length, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Non-covered by Medicare
Medicare does not cover the item or service this code describes.
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 statusN
Non-covered service. Medicare does not cover 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 A4490 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- 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 A4490
- Long descriptor
- Surgical stockings above knee length, each
- Short descriptor
- Above knee surgical stocking
- Added
- January 1, 1986
- 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 A4490
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4490 is not quite right, the correct code is very often within a few positions of it.
- A4466Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, eachterminated
- A4467Belt, strap, sleeve, garment, or covering, any type
- A4468Exsufflation belt, includes all supplies and accessories
- A4470Gravlee jet washer
- A4479Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type
- A4480Vabra aspirator
- A4481Tracheostoma filter, any type, any size, each
- A4483Moisture exchanger, disposable, for use with invasive mechanical ventilation
- A4495Surgical stockings thigh length, each
- A4500Surgical stockings below knee length, each
- A4510Surgical stockings full length, each
- A4520Incontinence garment, any type, (e.g., brief, diaper), each
- A4540Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
- A4541Monthly supplies for use of device coded at e0733
- A4542Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist
- A4543Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
Questions about A4490
What is HCPCS code A4490?
A4490 is a HCPCS Level II code for surgical stockings above knee length, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4490?
The CMS HCPCS file marks A4490 as "Non-covered by Medicare". Medicare does not cover the item or service this code describes.
How is A4490 paid under the physician fee schedule?
A4490 carries PFS status code N. Non-covered service. Medicare does not cover it.