A4261 HCPCS code: Cervical cap for contraceptive use
A4261 is the HCPCS Level II code for cervical cap for contraceptive use. Its Medicare coverage code is S (Non-covered by Medicare statute): Medicare is barred by law from covering it.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | S — Non-covered by Medicare statute |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 1999-01-01 |
| Last action effective | 1999-01-01 |
Related codes Medicare does pay
Medicare does not pay under A4261. These codes in the same A42 family carry a current DMEPOS fee:
- 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
What changed for A4261
- 1999-01-01: A4261 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 A4261?
A4261 is the HCPCS Level II code for cervical cap for contraceptive use. Short descriptor: "Cervical cap contraceptive".
Does Medicare cover A4261?
Coverage code S — Non-covered by Medicare statute. Medicare is barred by law from covering it.
Which related codes does Medicare pay instead of A4261?
Codes in the same A42 family with a DMEPOS fee include A4216 ($0.53–$0.99), A4217 ($2.18–$4.93). Check the item matches the code's descriptor before billing.
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 A4261
- Watch A4261 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4261
Sources: CMS HCPCS Level II release October 2025; 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.