A5072 — Ostomy pouch, urinary; without barrier attached (1 piece), each
A5072 is a HCPCS Level II code for ostomy pouch, urinary; without barrier attached (1 piece), 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 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 A5072 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 A5072
- Long descriptor
- Ostomy pouch, urinary; without barrier attached (1 piece), each
- Short descriptor
- Urinary pouch w/o barrier
- Added
- January 1, 1990
- 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 A5072
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A5072 is not quite right, the correct code is very often within a few positions of it.
- A5054Ostomy pouch, closed; for use on barrier with flange (2 piece), each
- A5055Stoma cap
- A5056Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
- A5057Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
- A5061Ostomy pouch, drainable; with barrier attached, (1 piece), each
- A5062Ostomy pouch, drainable; without barrier attached (1 piece), each
- A5063Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
- A5071Ostomy pouch, urinary; with barrier attached (1 piece), each
- A5073Ostomy pouch, urinary; for use on barrier with flange (2 piece), each
- A5081Stoma plug or seal, any type
- A5082Continent device; catheter for continent stoma
- A5083Continent device, stoma absorptive cover for continent stoma
- A5093Ostomy accessory; convex insert
- A5102Bedside drainage bottle with or without tubing, rigid or expandable, each
- A5105Urinary suspensory with leg bag, with or without tube, each
- A5112Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each
Questions about A5072
What is HCPCS code A5072?
A5072 is a HCPCS Level II code for ostomy pouch, urinary; without barrier attached (1 piece), each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A5072?
The CMS HCPCS file marks A5072 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 A5072 paid under the physician fee schedule?
A5072 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.