A4565 HCPCS code: Slings
A4565 is the HCPCS Level II code for slings. The 2026 Medicare DMEPOS fee schedule pays $10.98 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 outpatient hospital claims. Medicare volume fell 14% from 2022 to 2024 (21,211 to 18,220 services). In 2024, about 7,820 clinicians billed Medicare for A4565 for 17,852 beneficiaries; California, Illinois, Maryland accounted for 27% of services. Its average fee ranks 4 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 | 55 |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 1983-01-01 |
| Last action effective | 2014-10-01 |
2026 Medicare DMEPOS fee schedule for A4565
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $10.98 | $10.98 | $10.98 | $9.33 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $10.98 | — |
| AL | — | $10.98 | — |
| AR | — | $10.98 | — |
| AZ | — | $10.98 | — |
| CA | — | $10.98 | — |
| CO | — | $10.98 | — |
| CT | — | $10.98 | — |
| DC | — | $10.98 | — |
| DE | — | $10.98 | — |
| FL | — | $10.98 | — |
| GA | — | $10.98 | — |
| HI | — | $10.98 | — |
| IA | — | $10.98 | — |
| ID | — | $10.98 | — |
| IL | — | $10.98 | — |
| IN | — | $10.98 | — |
| KS | — | $10.98 | — |
| KY | — | $10.98 | — |
| LA | — | $10.98 | — |
| MA | — | $10.98 | — |
| MD | — | $10.98 | — |
| ME | — | $10.98 | — |
| MI | — | $10.98 | — |
| MN | — | $10.98 | — |
| MO | — | $10.98 | — |
| MS | — | $10.98 | — |
| MT | — | $10.98 | — |
| NC | — | $10.98 | — |
| ND | — | $10.98 | — |
| NE | — | $10.98 | — |
| NH | — | $10.98 | — |
| NJ | — | $10.98 | — |
| NM | — | $10.98 | — |
| NV | — | $10.98 | — |
| NY | — | $10.98 | — |
| OH | — | $10.98 | — |
| OK | — | $10.98 | — |
| OR | — | $10.98 | — |
| PA | — | $10.98 | — |
| PR | — | $10.98 | — |
| RI | — | $10.98 | — |
| SC | — | $10.98 | — |
| SD | — | $10.98 | — |
| TN | — | $10.98 | — |
| TX | — | $10.98 | — |
| UT | — | $10.98 | — |
| VA | — | $10.98 | — |
| VI | — | $10.98 | — |
| VT | — | $10.98 | — |
| WA | — | $10.98 | — |
| WI | — | $10.98 | — |
| WV | — | $10.98 | — |
| WY | — | $10.98 | — |
How the A4565 fee compares
| Measure | Value |
|---|---|
| Rank among 14 A45 codes (lowest = 1) | 4 |
| Family fee range (average of state fees) | $0.13–$1,672.60 |
| Rural fee uplift | — |
Who bills A4565 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 7,820 |
| Medicare beneficiaries | 17,852 |
| States with claims | 51 |
| Share of services in top 3 states (California, Illinois, Maryland) | 27% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4565, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 21,211 | 20,790 | $9.14 | $6.67 |
| 2023 | 19,854 | 19,463 | $9.82 | $7.21 |
| 2024 | 18,220 | 17,852 | $10.08 | $7.35 |
States with the most A4565 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 1,983 | $7.48 |
| Illinois | 1,499 | $7.61 |
| Maryland | 1,357 | $7.11 |
| Florida | 1,206 | $7.13 |
| Virginia | 1,039 | $7.29 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: Data |
| practitioner claims | 2 | Clinical: Data |
What changed for A4565
- 2026-01-01: Average state fee rose 2.0%: $10.76 to $10.98
- 1983-01-01: A4565 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 A4565?
A4565 is the HCPCS Level II code for slings. Short descriptor: "Slings".
How much does Medicare pay for A4565?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $10.98. Rural fees can be higher.
Does Medicare cover A4565?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A4565 change in 2026?
The average non-rural state fee moved from $10.76 in 2025 to $10.98 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4565 can be billed per day?
2 on outpatient hospital claims; 2 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 A4565
- Watch A4565 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4565
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.