A4452 HCPCS code: Tape, waterproof, per 18 square inches

A4452 is the HCPCS Level II code for tape, waterproof, per 18 square inches. The 2026 Medicare DMEPOS fee schedule pays $0.50 to $0.58 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 4 per day on outpatient hospital claims. Medicare volume fell 45% from 2022 to 2024 (10,986,905 to 6,096,969 services). In 2024, 978 suppliers billed Medicare for A4452 (purchases), serving 53,479 beneficiaries; Florida, Texas, New York accounted for 22% of services.

Code details

2026 Medicare DMEPOS fee schedule for A4452

How the A4452 fee compares

Who bills A4452 (2024)

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

Medicare utilization for A4452, 2022–2024

States with the most A4452 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52463: Facial Prostheses - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A52487: Ostomy Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A52492: Tracheostomy Care Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A52521: Urological Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
• A54563: Surgical Dressings - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (21 ICD-10-CM codes)

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

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

What changed for A4452

• 2026-01-01: Average state fee (AU) rose 2.0%: $0.49 to $0.50
• 2026-01-01: Average state fee (AV) rose 2.0%: $0.49 to $0.50
• 2026-01-01: Average state fee (AW) rose 1.9%: $0.53 to $0.54
• 2003-01-01: A4452 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 A4452?

A4452 is the HCPCS Level II code for tape, waterproof, per 18 square inches. Short descriptor: "Waterproof tape".

How much does Medicare pay for A4452?

Under the 2026 DMEPOS fee schedule, non-rural state fees are AU (OS): $0.50–$0.58; AV (OS): $0.50–$0.53; AW (OS): $0.54–$0.68. Rural fees can be higher.

Does Medicare cover A4452?

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

Which diagnoses support coverage for A4452?

Medicare policy articles that cite A4452 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 A4452 change in 2026?

The average non-rural state fee for AU moved from $0.49 in 2025 to $0.50 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4452 can be billed per day?

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

Related A44 codes

• A4400 — Ostomy irrigation set ($59.20–$90.97)
• A4402 — Lubricant, per ounce ($1.93–$5.70)
• 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)

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Next steps

• Run a reimbursement report for a device billed under A4452
• Watch A4452 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4452

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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