A4557 HCPCS code: Lead wires, (e.g., apnea monitor), per pair
A4557 is the HCPCS Level II code for lead wires, (e.g., apnea monitor), per pair. The 2026 Medicare DMEPOS fee schedule pays $12.04 to $20.61 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on DME suppliers. Medicare volume fell 19% from 2022 to 2024 (1,489 to 1,200 services). In 2024, 53 suppliers billed Medicare for A4557 (purchases), serving 872 beneficiaries; Ohio, New Jersey, New York accounted for 92% of services. Its average fee ranks 5 of 14 A45 codes (family range $0.13–$1,672.60); rural fees run 59% higher.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 34 — DMEPOS: supplies necessary for the effective use of DME |
| BETOS category | D1E — Other durable medical equipment |
| Added | 1984-01-01 |
| Last action effective | 2000-01-01 |
2026 Medicare DMEPOS fee schedule for A4557
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $12.04 | $20.61 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $17.89 | — |
| AL | — | $13.48 | $21.23 |
| AR | — | $13.48 | $22.06 |
| AZ | — | $12.04 | $19.81 |
| CA | — | $12.46 | $19.81 |
| CO | — | $12.10 | $22.06 |
| CT | — | $13.11 | $22.06 |
| DC | — | $12.51 | $19.81 |
| DE | — | $12.51 | $19.81 |
| FL | — | $13.48 | $22.06 |
| GA | — | $13.48 | $22.06 |
| HI | — | $18.65 | — |
| IA | — | $12.23 | $19.81 |
| ID | — | $12.10 | $22.06 |
| IL | — | $13.20 | $19.81 |
| IN | — | $13.20 | $19.81 |
| KS | — | $12.23 | $19.81 |
| KY | — | $13.48 | $22.06 |
| LA | — | $13.48 | $22.06 |
| MA | — | $13.11 | $22.06 |
| MD | — | $12.51 | $22.06 |
| ME | — | $13.11 | $22.06 |
| MI | — | $13.20 | $19.81 |
| MN | — | $12.23 | $19.81 |
| MO | — | $12.23 | $19.81 |
| MS | — | $13.48 | $19.81 |
| MT | — | $12.10 | $22.06 |
| NC | — | $13.48 | $22.06 |
| ND | — | $12.23 | $22.06 |
| NE | — | $12.23 | $19.81 |
| NH | — | $13.11 | $22.06 |
| NJ | — | $12.51 | $19.81 |
| NM | — | $12.04 | $21.98 |
| NV | — | $12.46 | $19.81 |
| NY | — | $12.51 | $20.61 |
| OH | — | $13.20 | $22.06 |
| OK | — | $12.04 | $19.81 |
| OR | — | $12.46 | $22.06 |
| PA | — | $12.51 | $19.81 |
| PR | — | $19.02 | — |
| RI | — | $13.11 | $22.06 |
| SC | — | $13.48 | $22.06 |
| SD | — | $12.23 | $22.06 |
| TN | — | $13.48 | $20.00 |
| TX | — | $12.04 | $22.06 |
| UT | — | $12.10 | $22.06 |
| VA | — | $13.48 | $19.87 |
| VI | — | $20.61 | — |
| VT | — | $13.11 | $22.06 |
| WA | — | $12.46 | $19.81 |
| WI | — | $13.20 | $22.06 |
| WV | — | $13.48 | $19.81 |
| WY | — | $12.10 | $22.06 |
How the A4557 fee compares
| Measure | Value |
|---|---|
| Rank among 14 A45 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $0.13–$1,672.60 |
| Rural fee uplift | 59.0% |
Who bills A4557 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 53 |
| Referring clinicians | 257 |
| Medicare beneficiaries | 872 |
| States with claims | 7 |
| Share of services in top 3 states (Ohio, New Jersey, New York) | 92% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 70 | 794 |
| 2023 | 52 | 649 |
| 2024 | 53 | 872 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4557, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,489 | 794 | $14.66 | $11.32 |
| 2023 | 962 | 649 | $15.56 | $12.02 |
| 2024 | 1,200 | 872 | $12.85 | $9.98 |
States with the most A4557 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Ohio | 420 | $10.85 |
| New Jersey | 360 | $9.19 |
| New York | 205 | $9.21 |
| Texas | 39 | $10.08 |
| California | 20 | $10.37 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Published Contractor Policy |
| outpatient hospital claims | 2 | Nature of Equipment |
Medicare policy articles for this code
- A52520: Transcutaneous Electrical Nerve Stimulators (TENS) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A52713: Transcutaneous Electrical Joint Stimulation Devices (TEJSD) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for A4557
- 2026-01-01: Average state fee rose 2.7%: $12.90 to $13.24
- 1984-01-01: A4557 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 A4557?
A4557 is the HCPCS Level II code for lead wires, (e.g., apnea monitor), per pair. Short descriptor: "Lead wires, pair".
How much does Medicare pay for A4557?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $12.04–$20.61. Rural fees can be higher.
Does Medicare cover A4557?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A4557 change in 2026?
The average non-rural state fee moved from $12.90 in 2025 to $13.24 in 2026 (+2.7%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4557 can be billed per day?
2 on DME suppliers; 2 on outpatient hospital claims (NCCI medically unlikely edits).
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
- A4540 — Distal transcutaneous electrical nerve stimulator, stimulates peripheral nerves of the upper arm
- 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
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 A4557
- Watch A4557 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4557
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.