A4649 — Surgical supply; miscellaneous
A4649 is a HCPCS Level II code for surgical supply; miscellaneous. 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 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 A4649 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
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 8 units 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 A4649
- Long descriptor
- Surgical supply; miscellaneous
- Short descriptor
- Surgical supplies
- Added
- January 1, 1982
- BETOS
- D1A
- Pricing indicator
- 46 — 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.
Carrier priced — not otherwise classified, individual determination, carrier discretion, or gap-filled amounts.
Codes adjacent to A4649
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4649 is not quite right, the correct code is very often within a few positions of it.
- A4636Replacement, handgrip, cane, crutch, or walker, each
- A4637Replacement, tip, cane, crutch, walker, each.
- A4638Replacement battery for patient-owned ear pulse generator, each
- A4639Replacement pad for infrared heating pad system, each
- A4640Replacement pad for use with medically necessary alternating pressure pad owned by patient
- A4641Radiopharmaceutical, diagnostic, not otherwise classified
- A4642Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
- A4648Tissue marker, implantable, any type, each
- A4650Implantable radiation dosimeter, each
- A4651Calibrated microcapillary tube, each
- A4652Microcapillary tube sealant
- A4653Peritoneal dialysis catheter anchoring device, belt, each
- A4657Syringe, with or without needle, each
- A4660Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
- A4663Blood pressure cuff only
- A4670Automatic blood pressure monitor
Questions about A4649
What is HCPCS code A4649?
A4649 is a HCPCS Level II code for surgical supply; miscellaneous. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4649?
The CMS HCPCS file marks A4649 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 A4649 paid under the physician fee schedule?
A4649 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.