A4220 HCPCS code: Refill kit for implantable infusion pump

A4220 is the HCPCS Level II code for refill kit for implantable infusion pump. In 2024 Medicare paid an average of $11.73 per service for A4220 across 5,903 services. 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 1 per day on outpatient hospital claims. Medicare volume fell 9% from 2022 to 2024 (6,456 to 5,903 services). In 2024, about 3 clinicians billed Medicare for A4220 for 1,498 beneficiaries.

Code details

Who bills A4220 (2024)

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

Medicare utilization for A4220, 2022–2024

States with the most A4220 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
• A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))

Covered diagnoses (2,020 ICD-10-CM codes)

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

Showing 10 of 2,020. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for A4220

• 1994-01-01: A4220 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 A4220?

A4220 is the HCPCS Level II code for refill kit for implantable infusion pump. Short descriptor: "Infusion pump refill kit".

How much does Medicare pay for A4220?

In 2024, the average Medicare payment was $11.73 per service (average allowed $15.13).

Does Medicare cover A4220?

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

Which diagnoses support coverage for A4220?

Medicare policy articles that cite A4220 list 2,020 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include A18.01 (Tuberculosis of spine), B02.23 (Postherpetic polyneuropathy), C00.0 (Malignant neoplasm of external upper lip). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

How many units of A4220 can be billed per day?

1 on outpatient hospital claims; 1 on practitioner 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)
• A4217 — Sterile water/saline, 500 ml ($2.18–$4.93)
• A4218 — Sterile saline or water, metered dose dispenser, 10 ml

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Next steps

• Run a reimbursement report for a device billed under A4220
• Watch A4220 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4220

Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; 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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