A4540 HCPCS code: Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
A4540 is the HCPCS Level II code for distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm. Its Medicare coverage code is S (Non-covered by Medicare statute): Medicare is barred by law from covering it.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | S — Non-covered by Medicare statute |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | Z2 |
| Added | 2024-01-01 |
| Last action effective | 2024-01-01 |
Related codes Medicare does pay
Medicare does not pay under A4540. These codes in the same A45 family carry a current DMEPOS fee:
- A4541 — Monthly supplies for use of device coded at e0733: $40.40–$49.25
- A4542 — Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist: $526.85–$526.85
- A4544 — Electrode for external lower extremity nerve stimulator for restless legs syndrome: $6.34–$6.34
- A4545 — Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month: $38.21–$55.51
What changed for A4540
- 2024-01-01: A4540 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 A4540?
A4540 is the HCPCS Level II code for distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm. Short descriptor: "Trans elec nerv periph nerv".
Does Medicare cover A4540?
Coverage code S — Non-covered by Medicare statute. Medicare is barred by law from covering it.
Which related codes does Medicare pay instead of A4540?
Codes in the same A45 family with a DMEPOS fee include A4541 ($40.40–$49.25), A4542 ($526.85–$526.85), A4544 ($6.34–$6.34). Check the item matches the code's descriptor before billing.
Related A45 codes
- A4500 — Surgical stockings below knee length, each
- A4510 — Surgical stockings full length, each
- A4520 — Incontinence garment, any type, (e.g., brief, diaper), each
- A4541 — Monthly supplies for use of device coded at e0733 ($40.40–$49.25)
- A4542 — Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist ($526.85–$526.85)
- A4543 — Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month
- A4544 — Electrode for external lower extremity nerve stimulator for restless legs syndrome ($6.34–$6.34)
- A4545 — Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month ($38.21–$55.51)
- A4550 — Surgical trays
- A4553 — Non-disposable underpads, all sizes
- A4554 — Disposable underpads, all sizes
- A4555 — Electrode/transducer for use with electrical stimulation device used for cancer treatment, replacement only
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 A4540
- Watch A4540 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4540
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.