A4559 HCPCS code: Coupling gel or paste, for use with ultrasound device, per oz
A4559 is the HCPCS Level II code for coupling gel or paste, for use with ultrasound device, per oz. The 2026 Medicare DMEPOS fee schedule pays $0.13 to $0.14 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 6 per day on DME suppliers. Its average fee ranks 1 of 14 A45 codes (family range $0.13–$1,672.60).
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 | 2007-01-01 |
| Last action effective | 2007-01-01 |
2026 Medicare DMEPOS fee schedule for A4559
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $0.13 | $0.14 | $0.13 | $0.11 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $0.13 | — |
| AL | — | $0.13 | — |
| AR | — | $0.13 | — |
| AZ | — | $0.13 | — |
| CA | — | $0.13 | — |
| CO | — | $0.13 | — |
| CT | — | $0.13 | — |
| DC | — | $0.13 | — |
| DE | — | $0.13 | — |
| FL | — | $0.13 | — |
| GA | — | $0.13 | — |
| HI | — | $0.13 | — |
| IA | — | $0.13 | — |
| ID | — | $0.13 | — |
| IL | — | $0.13 | — |
| IN | — | $0.13 | — |
| KS | — | $0.13 | — |
| KY | — | $0.13 | — |
| LA | — | $0.13 | — |
| MA | — | $0.13 | — |
| MD | — | $0.13 | — |
| ME | — | $0.13 | — |
| MI | — | $0.13 | — |
| MN | — | $0.13 | — |
| MO | — | $0.13 | — |
| MS | — | $0.13 | — |
| MT | — | $0.13 | — |
| NC | — | $0.13 | — |
| ND | — | $0.13 | — |
| NE | — | $0.13 | — |
| NH | — | $0.13 | — |
| NJ | — | $0.13 | — |
| NM | — | $0.13 | — |
| NV | — | $0.13 | — |
| NY | — | $0.13 | — |
| OH | — | $0.13 | — |
| OK | — | $0.13 | — |
| OR | — | $0.13 | — |
| PA | — | $0.13 | — |
| PR | — | $0.14 | — |
| RI | — | $0.13 | — |
| SC | — | $0.13 | — |
| SD | — | $0.13 | — |
| TN | — | $0.13 | — |
| TX | — | $0.13 | — |
| UT | — | $0.13 | — |
| VA | — | $0.13 | — |
| VI | — | $0.13 | — |
| VT | — | $0.13 | — |
| WA | — | $0.13 | — |
| WI | — | $0.13 | — |
| WV | — | $0.13 | — |
| WY | — | $0.13 | — |
How the A4559 fee compares
| Measure | Value |
|---|---|
| Rank among 14 A45 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $0.13–$1,672.60 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 6 | Nature of Equipment |
| outpatient hospital claims | 1 | Clinical: Data |
What changed for A4559
- 2007-01-01: A4559 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 A4559?
A4559 is the HCPCS Level II code for coupling gel or paste, for use with ultrasound device, per oz. Short descriptor: "Coupling gel or paste".
How much does Medicare pay for A4559?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $0.13–$0.14. Rural fees can be higher.
Does Medicare cover A4559?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A4559 change in 2026?
The average non-rural state fee moved from $0.13 in 2025 to $0.13 in 2026 (+0.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4559 can be billed per day?
6 on DME suppliers; 1 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
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Next steps
- Run a reimbursement report for a device billed under A4559
- Watch A4559 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4559
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.