A4222 HCPCS code: Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)

A4222 is the HCPCS Level II code for infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately). The 2026 Medicare DMEPOS fee schedule pays $49.07 to $62.94 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on outpatient hospital claims. Medicare volume fell 13% from 2022 to 2024 (655,025 to 571,275 services). In 2024, 504 suppliers billed Medicare for A4222 (purchases), serving 7,605 beneficiaries; Texas, California, Florida accounted for 26% of services. Its average fee ranks 17 of 18 A42 codes (family range $0.61–$273.28); rural fees run 15% higher.

Code details

2026 Medicare DMEPOS fee schedule for A4222

How the A4222 fee compares

Who bills A4222 (2024)

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

Medicare utilization for A4222, 2022–2024

States with the most A4222 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (460 ICD-10-CM codes)

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

Showing 10 of 460. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for A4222

• 2026-01-01: Average state fee rose 2.6%: $48.54 to $49.81
• 1997-01-01: A4222 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 A4222?

A4222 is the HCPCS Level II code for infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately). Short descriptor: "Infusion supplies with pump".

How much does Medicare pay for A4222?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $49.07–$62.94. Rural fees can be higher.

Does Medicare cover A4222?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

Which diagnoses support coverage for A4222?

Medicare policy articles that cite A4222 list 460 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C91.00 (Acute lymphoblastic leukemia not having achieved remission), C91.01 (Acute lymphoblastic leukemia, in remission), C91.02 (Acute lymphoblastic leukemia, in relapse). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for A4222 change in 2026?

The average non-rural state fee moved from $48.54 in 2025 to $49.81 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4222 can be billed per day?

2 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)
• 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 A4222
• Watch A4222 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4222

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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