A4562 HCPCS code: Pessary, reusable, non rubber, any type
A4562 is the HCPCS Level II code for pessary, reusable, non rubber, any type. The 2026 Medicare DMEPOS fee schedule pays $70.81 to $73.34 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 1 per day on outpatient hospital claims. Medicare volume rose 3% from 2022 to 2024 (38,351 to 39,645 services). In 2024, about 6,589 clinicians billed Medicare for A4562 for 30,597 beneficiaries; California, Florida, New York accounted for 23% of services. Its average fee ranks 12 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 | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2001-01-01 |
| Last action effective | 2024-04-01 |
2026 Medicare DMEPOS fee schedule for A4562
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $70.81 | $73.34 | $86.42 | $64.82 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | — | $72.96 | — |
| AR | — | $72.96 | — |
| AZ | — | $70.81 | — |
| CA | — | $70.81 | — |
| CO | — | $73.34 | — |
| CT | — | $70.81 | — |
| DC | — | $70.81 | — |
| DE | — | $70.81 | — |
| FL | — | $72.96 | — |
| GA | — | $72.96 | — |
| IA | — | $72.18 | — |
| ID | — | $70.81 | — |
| IL | — | $72.57 | — |
| IN | — | $72.57 | — |
| KS | — | $72.18 | — |
| KY | — | $72.96 | — |
| LA | — | $72.96 | — |
| MA | — | $70.81 | — |
| MD | — | $70.81 | — |
| ME | — | $70.81 | — |
| MI | — | $72.57 | — |
| MN | — | $72.57 | — |
| MO | — | $72.18 | — |
| MS | — | $72.96 | — |
| MT | — | $73.34 | — |
| NC | — | $72.96 | — |
| ND | — | $73.34 | — |
| NE | — | $72.18 | — |
| NH | — | $70.81 | — |
| NJ | — | $70.81 | — |
| NM | — | $72.96 | — |
| NV | — | $70.81 | — |
| NY | — | $70.81 | — |
| OH | — | $72.57 | — |
| OK | — | $72.96 | — |
| OR | — | $70.81 | — |
| PA | — | $70.81 | — |
| RI | — | $70.81 | — |
| SC | — | $72.96 | — |
| SD | — | $73.34 | — |
| TN | — | $72.96 | — |
| TX | — | $72.96 | — |
| UT | — | $73.34 | — |
| VA | — | $70.81 | — |
| VT | — | $70.81 | — |
| WA | — | $70.81 | — |
| WI | — | $72.57 | — |
| WV | — | $70.81 | — |
| WY | — | $73.34 | — |
How the A4562 fee compares
| Measure | Value |
|---|---|
| Rank among 14 A45 codes (lowest = 1) | 12 |
| Family fee range (average of state fees) | $0.13–$1,672.60 |
| Rural fee uplift | — |
Who bills A4562 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 6,589 |
| Medicare beneficiaries | 30,597 |
| States with claims | 51 |
| Share of services in top 3 states (California, Florida, New York) | 23% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4562, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 38,351 | 30,193 | $60.25 | $44.68 |
| 2023 | 39,562 | 30,801 | $64.64 | $48.32 |
| 2024 | 39,645 | 30,597 | $66.43 | $49.39 |
States with the most A4562 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 3,326 | $49.79 |
| Florida | 2,985 | $50.66 |
| New York | 2,642 | $50.50 |
| Pennsylvania | 2,206 | $49.13 |
| Texas | 2,171 | $50.75 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Nature of Equipment |
| practitioner claims | 1 | Nature of Equipment |
What changed for A4562
- 2026-01-01: Average state fee rose 2.0%: $70.60 to $72.02
- 2001-01-01: A4562 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 A4562?
A4562 is the HCPCS Level II code for pessary, reusable, non rubber, any type. Short descriptor: "Pessary reusable nonrubber".
How much does Medicare pay for A4562?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $70.81–$73.34. Rural fees can be higher.
Does Medicare cover A4562?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A4562 change in 2026?
The average non-rural state fee moved from $70.60 in 2025 to $72.02 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4562 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner 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 A4562
- Watch A4562 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4562
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.