A4402 HCPCS code: Lubricant, per ounce
A4402 is the HCPCS Level II code for lubricant, per ounce. The 2026 Medicare DMEPOS fee schedule pays $1.93 to $5.70 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 1 per day on outpatient hospital claims. Medicare volume fell 18% from 2022 to 2024 (378,039 to 311,734 services). In 2024, 1,165 suppliers billed Medicare for A4402 (purchases), serving 9,505 beneficiaries; California, Minnesota, Texas accounted for 26% of services. Its average fee ranks 7 of 42 A44 codes (family range $0.15–$160.42).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 37 — DMEPOS: ostomy, tracheostomy and urological supplies |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1985-01-01 |
| Last action effective | 1995-01-01 |
2026 Medicare DMEPOS fee schedule for A4402
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1.93 | $5.70 | $2.27 | $1.93 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $5.36 | — |
| AL | — | $2.27 | — |
| AR | — | $2.27 | — |
| AZ | — | $2.27 | — |
| CA | — | $2.27 | — |
| CO | — | $2.27 | — |
| CT | — | $1.93 | — |
| DC | — | $1.99 | — |
| DE | — | $1.99 | — |
| FL | — | $2.02 | — |
| GA | — | $1.93 | — |
| HI | — | $5.70 | — |
| IA | — | $2.27 | — |
| ID | — | $1.99 | — |
| IL | — | $1.93 | — |
| IN | — | $1.93 | — |
| KS | — | $2.18 | — |
| KY | — | $1.93 | — |
| LA | — | $2.27 | — |
| MA | — | $1.93 | — |
| MD | — | $2.27 | — |
| ME | — | $2.27 | — |
| MI | — | $2.27 | — |
| MN | — | $2.27 | — |
| MO | — | $2.18 | — |
| MS | — | $1.93 | — |
| MT | — | $2.27 | — |
| NC | — | $1.93 | — |
| ND | — | $2.27 | — |
| NE | — | $2.18 | — |
| NH | — | $1.93 | — |
| NJ | — | $1.99 | — |
| NM | — | $1.99 | — |
| NV | — | $2.27 | — |
| NY | — | $2.27 | — |
| OH | — | $2.27 | — |
| OK | — | $1.99 | — |
| OR | — | $2.27 | — |
| PA | — | $1.99 | — |
| PR | — | $4.51 | — |
| RI | — | $1.93 | — |
| SC | — | $2.27 | — |
| SD | — | $2.27 | — |
| TN | — | $1.93 | — |
| TX | — | $2.27 | — |
| UT | — | $2.27 | — |
| VA | — | $2.27 | — |
| VI | — | $2.27 | — |
| VT | — | $2.18 | — |
| WA | — | $2.27 | — |
| WI | — | $2.27 | — |
| WV | — | $2.27 | — |
| WY | — | $2.27 | — |
How the A4402 fee compares
| Measure | Value |
|---|---|
| Rank among 42 A44 codes (lowest = 1) | 7 |
| Family fee range (average of state fees) | $0.15–$160.42 |
| Rural fee uplift | — |
Who bills A4402 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1,165 |
| Referring clinicians | 7,892 |
| Medicare beneficiaries | 9,505 |
| States with claims | 53 |
| Share of services in top 3 states (California, Minnesota, Texas) | 26% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,242 | 11,171 |
| 2023 | 1,196 | 10,392 |
| 2024 | 1,165 | 9,505 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4402, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 378,039 | 11,171 | $1.84 | $1.38 |
| 2023 | 342,609 | 10,392 | $1.99 | $1.48 |
| 2024 | 311,734 | 9,505 | $2.06 | $1.54 |
States with the most A4402 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 39,092 | $1.57 |
| Minnesota | 22,154 | $1.61 |
| Texas | 19,089 | $1.62 |
| Michigan | 16,917 | $1.55 |
| New York | 15,351 | $1.60 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
What changed for A4402
- 2026-01-01: Average state fee rose 1.8%: $2.27 to $2.32
- 1985-01-01: A4402 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 A4402?
A4402 is the HCPCS Level II code for lubricant, per ounce. Short descriptor: "Lubricant per ounce".
How much does Medicare pay for A4402?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1.93–$5.70. Rural fees can be higher.
Does Medicare cover A4402?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A4402 change in 2026?
The average non-rural state fee moved from $2.27 in 2025 to $2.32 in 2026 (+1.8%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4402 can be billed per day?
1 on outpatient hospital claims (NCCI medically unlikely edits).
Related A44 codes
- A4400 — Ostomy irrigation set ($59.20–$90.97)
- A4404 — Ostomy ring, each ($2.03–$2.60)
- A4405 — Ostomy skin barrier, non-pectin based, paste, per ounce ($4.87–$5.76)
- A4406 — Ostomy skin barrier, pectin-based, paste, per ounce ($8.16–$9.78)
- A4407 — Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each ($12.48–$14.94)
- A4408 — Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each ($14.07–$16.87)
- A4409 — Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each ($8.84–$10.60)
- A4410 — Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each ($12.88–$15.43)
- A4411 — Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each ($7.26–$8.70)
- A4412 — Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each ($3.86–$4.56)
- A4413 — Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each ($7.85–$9.44)
- A4414 — Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each ($7.01–$8.39)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A4402
- Watch A4402 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4402
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.