A4217 HCPCS code: Sterile water/saline, 500 ml

A4217 is the HCPCS Level II code for sterile water/saline, 500 ml. The 2026 Medicare DMEPOS fee schedule pays $2.18 to $4.93 depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 4 per day on outpatient hospital claims. Medicare volume fell 6% from 2022 to 2024 (382,597 to 359,919 services). In 2024, 714 suppliers billed Medicare for A4217 (purchases), serving 3,293 beneficiaries; California, New York, Minnesota accounted for 42% of services. Its average fee ranks 7 of 18 A42 codes (family range $0.61–$273.28).

Code details

2026 Medicare DMEPOS fee schedule for A4217

How the A4217 fee compares

Who bills A4217 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for A4217, 2022–2024

States with the most A4217 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52466: Nebulizers - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A52519: Suction Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A52521: Urological Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (222 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 222. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for A4217

• 2026-01-01: Average state fee rose 2.1%: $4.06 to $4.14
• 2026-01-01: Average state fee (AU) rose 2.1%: $4.06 to $4.14
• 2004-01-01: A4217 added to HCPCS Level II
• Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01

Frequently asked questions

What is HCPCS code A4217?

A4217 is the HCPCS Level II code for sterile water/saline, 500 ml. Short descriptor: "Sterile water/saline, 500 ml".

How much does Medicare pay for A4217?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $2.18–$4.93; AU (OS): $2.18–$4.93. Rural fees can be higher.

Does Medicare cover A4217?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Which diagnoses support coverage for A4217?

Medicare policy articles that cite A4217 list 222 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include Z43.0 (Encounter for attention to tracheostomy), Z93.0 (Tracheostomy status), A15.0 (Tuberculosis of lung). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for A4217 change in 2026?

The average non-rural state fee moved from $4.06 in 2025 to $4.14 in 2026 (+2.1%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4217 can be billed per day?

4 on outpatient hospital claims (NCCI medically unlikely edits).

Related A42 codes

• A4206 — Syringe with needle, sterile, 1 cc or less, each
• A4207 — Syringe with needle, sterile 2 cc, each
• A4208 — Syringe with needle, sterile 3 cc, each
• A4209 — Syringe with needle, sterile 5 cc or greater, each
• A4210 — Needle-free injection device, each
• A4211 — Supplies for self-administered injections
• A4212 — Non-coring needle or stylet with or without catheter
• A4213 — Syringe, sterile, 20 cc or greater, each
• A4215 — Needle, sterile, any size, each
• A4216 — Sterile water, saline and/or dextrose, diluent/flush, 10 ml ($0.53–$0.99)
• A4218 — Sterile saline or water, metered dose dispenser, 10 ml
• A4220 — Refill kit for implantable infusion pump

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Next steps

• Run a reimbursement report for a device billed under A4217
• Watch A4217 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4217

Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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