A4266 HCPCS code: Diaphragm for contraceptive use
A4266 is the HCPCS Level II code for diaphragm for contraceptive use. Its Medicare coverage code is I (Not payable by Medicare): Medicare does not pay separately under this code; another code applies.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | I — Not payable by Medicare |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2003-01-01 |
| Last action effective | 2003-01-01 |
Related codes Medicare does pay
Medicare does not pay under A4266. 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 A4266
- 2003-01-01: A4266 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 A4266?
A4266 is the HCPCS Level II code for diaphragm for contraceptive use. Short descriptor: "Diaphragm".
Does Medicare cover A4266?
Coverage code I — Not payable by Medicare. Medicare does not pay separately under this code; another code applies.
Which related codes does Medicare pay instead of A4266?
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 A4266
- Watch A4266 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4266
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.