A4455 HCPCS code: Adhesive remover or solvent (for tape, cement or other adhesive), per ounce
A4455 is the HCPCS Level II code for adhesive remover or solvent (for tape, cement or other adhesive), per ounce. The 2026 Medicare DMEPOS fee schedule pays $1.62 to $2.42 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. Its average fee ranks 4 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 | 1989-01-01 |
| Last action effective | 1995-01-01 |
2026 Medicare DMEPOS fee schedule for A4455
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1.62 | $2.42 | $2.03 | $1.73 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $2.27 | — |
| AL | — | $2.03 | — |
| AR | — | $2.03 | — |
| AZ | — | $1.73 | — |
| CA | — | $2.03 | — |
| CO | — | $2.03 | — |
| CT | — | $2.03 | — |
| DC | — | $2.00 | — |
| DE | — | $2.00 | — |
| FL | — | $1.73 | — |
| GA | — | $2.03 | — |
| HI | — | $2.42 | — |
| IA | — | $2.03 | — |
| ID | — | $2.03 | — |
| IL | — | $1.76 | — |
| IN | — | $1.73 | — |
| KS | — | $2.03 | — |
| KY | — | $1.73 | — |
| LA | — | $2.03 | — |
| MA | — | $2.03 | — |
| MD | — | $2.03 | — |
| ME | — | $2.03 | — |
| MI | — | $2.03 | — |
| MN | — | $1.79 | — |
| MO | — | $2.00 | — |
| MS | — | $2.03 | — |
| MT | — | $1.76 | — |
| NC | — | $1.73 | — |
| ND | — | $2.03 | — |
| NE | — | $2.03 | — |
| NH | — | $2.03 | — |
| NJ | — | $2.00 | — |
| NM | — | $1.73 | — |
| NV | — | $1.73 | — |
| NY | — | $1.73 | — |
| OH | — | $2.03 | — |
| OK | — | $1.73 | — |
| OR | — | $2.03 | — |
| PA | — | $2.00 | — |
| PR | — | $1.62 | — |
| RI | — | $2.03 | — |
| SC | — | $2.01 | — |
| SD | — | $2.03 | — |
| TN | — | $1.73 | — |
| TX | — | $1.73 | — |
| UT | — | $1.76 | — |
| VA | — | $2.02 | — |
| VI | — | $1.73 | — |
| VT | — | $2.03 | — |
| WA | — | $2.03 | — |
| WI | — | $1.73 | — |
| WV | — | $2.03 | — |
| WY | — | $2.03 | — |
How the A4455 fee compares
| Measure | Value |
|---|---|
| Rank among 42 A44 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $0.15–$160.42 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
What changed for A4455
- 2026-01-01: Average state fee rose 2.1%: $1.90 to $1.94
- 1989-01-01: A4455 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 A4455?
A4455 is the HCPCS Level II code for adhesive remover or solvent (for tape, cement or other adhesive), per ounce. Short descriptor: "Adhesive remover per ounce".
How much does Medicare pay for A4455?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1.62–$2.42. Rural fees can be higher.
Does Medicare cover A4455?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A4455 change in 2026?
The average non-rural state fee moved from $1.90 in 2025 to $1.94 in 2026 (+2.1%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4455 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)
- 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 A4455
- Watch A4455 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4455
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.