K0455 — Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
K0455 is a HCPCS Level II code for infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol). It belongs to the Durable Medical Equipment (DME MAC Temporary) 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.
Medically Unlikely Edits — units per day
The most units of K0455 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
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
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 K0455
- Long descriptor
- Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)
- Short descriptor
- Pump uninterrupted infusion
- Added
- January 1, 1998
- BETOS
- D1E
- Pricing indicator
- 31 — 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.
Frequently serviced DME. Price subject to floors and ceilings.
Codes adjacent to K0455
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If K0455 is not quite right, the correct code is very often within a few positions of it.
- K0071Front caster assembly, complete, with pneumatic tire, replacement only, each
- K0072Front caster assembly, complete, with semi-pneumatic tire, replacement only, each
- K0073Caster pin lock, each
- K0077Front caster assembly, complete, with solid tire, replacement only, each
- K0098Drive belt for power wheelchair, replacement only
- K0105Iv hanger, each
- K0108Wheelchair component or accessory, not otherwise specified
- K0195Elevating leg rests, pair (for use with capped rental wheelchair base)
- K0462Temporary replacement for patient owned equipment being repaired, any type
- K0552Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
- K0553Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of serviceterminated
- K0554Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor systemterminated
- K0601Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each
- K0602Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each
- K0603Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each
- K0604Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each
Questions about K0455
What is HCPCS code K0455?
K0455 is a HCPCS Level II code for infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol). It sits in the Durable Medical Equipment (DME MAC Temporary) section.
Does Medicare cover K0455?
The CMS HCPCS file marks K0455 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.