A4450 HCPCS code: Tape, non-waterproof, per 18 square inches

A4450 is the HCPCS Level II code for tape, non-waterproof, per 18 square inches. The 2026 Medicare DMEPOS fee schedule pays $0.10 to $0.14 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 20 per day on outpatient hospital claims. Medicare volume fell 15% from 2022 to 2024 (5,788,680 to 4,911,781 services). In 2024, 932 suppliers billed Medicare for A4450 (purchases), serving 44,924 beneficiaries; Florida, New York, California accounted for 26% of services.

Code details

FieldValue
SectionA codes — Transportation, medical/surgical supplies and miscellaneous
Coverage codeD — Special coverage instructions apply
Pricing indicator37 — DMEPOS: ostomy, tracheostomy and urological supplies
BETOS categoryD1F — Prosthetic and orthotic devices
Added2003-01-01
Last action effective2003-01-01

2026 Medicare DMEPOS fee schedule for A4450

ModifierMeaningLowest state feeHighest state feeCeilingFloor
AUOS$0.10$0.14$0.10$0.09
AVOS$0.10$0.14$0.10$0.09
AWOS$0.14$0.16$0.14$0.12
StateModifierFeeRural fee
AKAU$0.10—
ALAU$0.10—
ARAU$0.10—
AZAU$0.10—
CAAU$0.10—
COAU$0.10—
CTAU$0.10—
DCAU$0.10—
DEAU$0.10—
FLAU$0.10—
GAAU$0.10—
HIAU$0.10—
IAAU$0.10—
IDAU$0.10—
ILAU$0.10—
INAU$0.10—
KSAU$0.10—
KYAU$0.10—
LAAU$0.10—
MAAU$0.10—
MDAU$0.10—
MEAU$0.10—
MIAU$0.10—
MNAU$0.10—
MOAU$0.10—
MSAU$0.10—
MTAU$0.10—
NCAU$0.10—
NDAU$0.10—
NEAU$0.10—
NHAU$0.10—
NJAU$0.10—
NMAU$0.10—
NVAU$0.10—
NYAU$0.10—
OHAU$0.10—
OKAU$0.10—
ORAU$0.10—
PAAU$0.10—
PRAU$0.14—
RIAU$0.10—
SCAU$0.10—
SDAU$0.10—
TNAU$0.10—
TXAU$0.10—
UTAU$0.10—
VAAU$0.10—
VIAU$0.10—
VTAU$0.10—
WAAU$0.10—
WIAU$0.10—
WVAU$0.10—
WYAU$0.10—
AKAV$0.10—
ALAV$0.10—
ARAV$0.10—
AZAV$0.10—
CAAV$0.10—
COAV$0.10—
CTAV$0.10—
DCAV$0.10—
DEAV$0.10—
FLAV$0.10—
GAAV$0.10—
HIAV$0.10—
IAAV$0.10—
IDAV$0.10—
ILAV$0.10—
INAV$0.10—
KSAV$0.10—
KYAV$0.10—
LAAV$0.10—
MAAV$0.10—
MDAV$0.10—
MEAV$0.10—
MIAV$0.10—
MNAV$0.10—
MOAV$0.10—
MSAV$0.10—
MTAV$0.10—
NCAV$0.10—
NDAV$0.10—
NEAV$0.10—
NHAV$0.10—
NJAV$0.10—
NMAV$0.10—
NVAV$0.10—
NYAV$0.10—
OHAV$0.10—
OKAV$0.10—
ORAV$0.10—
PAAV$0.10—
PRAV$0.14—
RIAV$0.10—
SCAV$0.10—
SDAV$0.10—
TNAV$0.10—
TXAV$0.10—
UTAV$0.10—
VAAV$0.10—
VIAV$0.10—
VTAV$0.10—
WAAV$0.10—
WIAV$0.10—
WVAV$0.10—
WYAV$0.10—
AKAW$0.14—
ALAW$0.14—
ARAW$0.14—
AZAW$0.14—
CAAW$0.14—
COAW$0.14—
CTAW$0.14—
DCAW$0.14—
DEAW$0.14—
FLAW$0.14—
GAAW$0.14—
HIAW$0.14—
IAAW$0.14—
IDAW$0.14—
ILAW$0.14—
INAW$0.14—
KSAW$0.14—
KYAW$0.14—
LAAW$0.14—
MAAW$0.14—
MDAW$0.14—
MEAW$0.14—
MIAW$0.14—
MNAW$0.14—
MOAW$0.14—
MSAW$0.14—
MTAW$0.14—
NCAW$0.14—
NDAW$0.14—
NEAW$0.14—
NHAW$0.14—
NJAW$0.14—
NMAW$0.14—
NVAW$0.14—
NYAW$0.14—
OHAW$0.14—
OKAW$0.14—
ORAW$0.14—
PAAW$0.14—
PRAW$0.16—
RIAW$0.14—
SCAW$0.14—
SDAW$0.14—
TNAW$0.14—
TXAW$0.14—
UTAW$0.14—
VAAW$0.14—
VIAW$0.14—
VTAW$0.14—
WAAW$0.14—
WIAW$0.14—
WVAW$0.14—
WYAW$0.14—

How the A4450 fee compares

MeasureValue
Rank among 2 A44 codes billed AU (lowest = 1)1
Family fee range (average of state fees)$0.10–$0.50
Rural fee uplift—

Who bills A4450 (2024)

MeasureValue
Suppliers billing rentals—
Suppliers billing purchases932
Referring clinicians16,210
Medicare beneficiaries44,924
States with claims54
Share of services in top 3 states (Florida, New York, California)26%
YearSuppliersBeneficiaries
20221,30946,804
20231,14346,769
202493244,924

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

Medicare utilization for A4450, 2022–2024

YearServicesBeneficiariesAvg. allowedAvg. paid
20225,788,68046,804$0.12$0.10
20235,174,97346,769$0.13$0.10
20244,911,78144,924$0.13$0.10

States with the most A4450 services (2024)

StateServicesAvg. paid
Florida521,790$0.10
New York385,402$0.10
California357,506$0.10
Pennsylvania281,205$0.10
Ohio267,555$0.10

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims20Clinical: CMS Workgroup

Medicare policy articles for this code

Covered diagnoses (21 ICD-10-CM codes)

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

ICD-10-CMDiagnosisArticles listing it
J95.00Unspecified tracheostomy complication1
J95.01Hemorrhage from tracheostomy stoma1
J95.02Infection of tracheostomy stoma1
J95.03Malfunction of tracheostomy stoma1
J95.04Tracheo-esophageal fistula following tracheostomy1
J95.09Other tracheostomy complication1
K94.00Colostomy complication, unspecified1
K94.03Colostomy malfunction1
K94.10Enterostomy complication, unspecified1
K94.13Enterostomy malfunction1

Showing 10 of 21. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for A4450

Frequently asked questions

What is HCPCS code A4450?

A4450 is the HCPCS Level II code for tape, non-waterproof, per 18 square inches. Short descriptor: "Non-waterproof tape".

How much does Medicare pay for A4450?

Under the 2026 DMEPOS fee schedule, non-rural state fees are AU (OS): $0.10–$0.14; AV (OS): $0.10–$0.14; AW (OS): $0.14–$0.16. Rural fees can be higher.

Does Medicare cover A4450?

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

Which diagnoses support coverage for A4450?

Medicare policy articles that cite A4450 list 21 covered ICD-10-CM diagnosis codes across 5 articles. The most cited include J95.00 (Unspecified tracheostomy complication), J95.01 (Hemorrhage from tracheostomy stoma), J95.02 (Infection of tracheostomy stoma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for A4450 change in 2026?

The average non-rural state fee for AU moved from $0.10 in 2025 to $0.10 in 2026 (+0.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4450 can be billed per day?

20 on outpatient hospital claims (NCCI medically unlikely edits).

Related A44 codes

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

Sources: CMS HCPCS Level II release October 2026; 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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