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A4690

A4690Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each

HCPCSActiveBETOS P9B

A4690 is a HCPCS Level II code for dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each. 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 statusX

Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays 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 A4690 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 A4690

Long descriptor
Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each

The official wording. This is what the code means.

Short descriptor
Dialyzer, each

CMS's 28-character form, which is what shows up on a remittance advice.

Added
January 1, 1986

When CMS introduced the code.

BETOS
P9B

Berenson-Eggers Type of Service — CMS's own analytic grouping.

Pricing indicator
00 — Not priced by Part B

Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.

Codes adjacent to A4690

HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4690 is not quite right, the correct code is very often within a few positions of it.

  • A4660Sphygmomanometer/blood pressure apparatus with cuff and stethoscope
  • A4663Blood pressure cuff only
  • A4670Automatic blood pressure monitor
  • A4671Disposable cycler set used with cycler dialysis machine, each
  • A4672Drainage extension line, sterile, for dialysis, each
  • A4673Extension line with easy lock connectors, used with dialysis
  • A4674Chemicals/antiseptics solution used to clean/sterilize dialysis equipment, per 8 oz
  • A4680Activated carbon filter for hemodialysis, each
  • A4706Bicarbonate concentrate, solution, for hemodialysis, per gallon
  • A4707Bicarbonate concentrate, powder, for hemodialysis, per packet
  • A4708Acetate concentrate solution, for hemodialysis, per gallon
  • A4709Acid concentrate, solution, for hemodialysis, per gallon
  • A4714Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
  • A4719"y set" tubing for peritoneal dialysis
  • A4720Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
  • A4721Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis

Questions about A4690

What is HCPCS code A4690?

A4690 is a HCPCS Level II code for dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.

Does Medicare cover A4690?

The CMS HCPCS file marks A4690 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 A4690 paid under the physician fee schedule?

A4690 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.

HCPCS Level II2026Q3-Jul· effective July 1, 2026