A4605 HCPCS code: Tracheal suction catheter, closed system, each
A4605 is the HCPCS Level II code for tracheal suction catheter, closed system, each. The 2026 Medicare DMEPOS fee schedule pays $23.31 to $27.99 (NU, new equipment, purchased) 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 90 per day on DME suppliers. Medicare volume fell 1% from 2022 to 2024 (164,751 to 163,003 services). In 2024, 506 suppliers billed Medicare for A4605 (purchases), serving 1,737 beneficiaries; California, New York, New Jersey accounted for 42% of services. Its average fee ranks 10 of 13 A46 codes billed NU (family range $2.30–$66.87).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 32 — DMEPOS: inexpensive or routinely purchased item |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2005-01-01 |
| Last action effective | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for A4605
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| NU | new equipment, purchased | $23.31 | $27.99 | $23.38 | $19.87 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | NU | $23.38 | — |
| AL | NU | $23.38 | — |
| AR | NU | $23.38 | — |
| AZ | NU | $23.38 | — |
| CA | NU | $23.38 | — |
| CO | NU | $23.38 | — |
| CT | NU | $23.38 | — |
| DC | NU | $23.38 | — |
| DE | NU | $23.38 | — |
| FL | NU | $23.38 | — |
| GA | NU | $23.38 | — |
| HI | NU | $23.38 | — |
| IA | NU | $23.38 | — |
| ID | NU | $23.38 | — |
| IL | NU | $23.38 | — |
| IN | NU | $23.38 | — |
| KS | NU | $23.38 | — |
| KY | NU | $23.38 | — |
| LA | NU | $23.38 | — |
| MA | NU | $23.38 | — |
| MD | NU | $23.31 | — |
| ME | NU | $23.38 | — |
| MI | NU | $23.38 | — |
| MN | NU | $23.38 | — |
| MO | NU | $23.38 | — |
| MS | NU | $23.38 | — |
| MT | NU | $23.38 | — |
| NC | NU | $23.38 | — |
| ND | NU | $23.38 | — |
| NE | NU | $23.38 | — |
| NH | NU | $23.38 | — |
| NJ | NU | $23.38 | — |
| NM | NU | $23.38 | — |
| NV | NU | $23.38 | — |
| NY | NU | $23.38 | — |
| OH | NU | $23.38 | — |
| OK | NU | $23.38 | — |
| OR | NU | $23.38 | — |
| PA | NU | $23.38 | — |
| PR | NU | $27.99 | — |
| RI | NU | $23.38 | — |
| SC | NU | $23.38 | — |
| SD | NU | $23.38 | — |
| TN | NU | $23.38 | — |
| TX | NU | $23.38 | — |
| UT | NU | $23.38 | — |
| VA | NU | $23.38 | — |
| VI | NU | $23.38 | — |
| VT | NU | $23.38 | — |
| WA | NU | $23.38 | — |
| WI | NU | $23.38 | — |
| WV | NU | $23.38 | — |
| WY | NU | $23.38 | — |
How the A4605 fee compares
| Measure | Value |
|---|---|
| Rank among 13 A46 codes billed NU (lowest = 1) | 10 |
| Family fee range (average of state fees) | $2.30–$66.87 |
| Rural fee uplift | — |
Who bills A4605 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 506 |
| Referring clinicians | 1,908 |
| Medicare beneficiaries | 1,737 |
| States with claims | 46 |
| Share of services in top 3 states (California, New York, New Jersey) | 42% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 488 | 1,700 |
| 2023 | 498 | 1,658 |
| 2024 | 506 | 1,737 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4605, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 164,751 | 1,700 | $19.99 | $15.59 |
| 2023 | 161,226 | 1,658 | $21.71 | $16.87 |
| 2024 | 163,003 | 1,737 | $22.33 | $17.37 |
States with the most A4605 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 42,167 | $17.47 |
| New York | 17,123 | $17.49 |
| New Jersey | 9,126 | $17.52 |
| Texas | 8,500 | $16.63 |
| Florida | 7,937 | $17.47 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 90 | Nature of Equipment |
| outpatient hospital claims | 1 | Clinical: CMS Workgroup |
Medicare policy articles for this code
- A52519: Suction Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (8 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| J95.00 | Unspecified tracheostomy complication | 1 |
| J95.01 | Hemorrhage from tracheostomy stoma | 1 |
| J95.02 | Infection of tracheostomy stoma | 1 |
| J95.03 | Malfunction of tracheostomy stoma | 1 |
| J95.04 | Tracheo-esophageal fistula following tracheostomy | 1 |
| J95.09 | Other tracheostomy complication | 1 |
| Z43.0 | Encounter for attention to tracheostomy | 1 |
| Z93.0 | Tracheostomy status | 1 |
What changed for A4605
- 2026-01-01: Average state fee (NU) rose 2.0%: $23.00 to $23.47
- 2005-01-01: A4605 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 A4605?
A4605 is the HCPCS Level II code for tracheal suction catheter, closed system, each. Short descriptor: "Trach suction cath close sys".
How much does Medicare pay for A4605?
Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $23.31–$27.99. Rural fees can be higher.
Does Medicare cover A4605?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for A4605?
Medicare policy articles that cite A4605 list 8 covered ICD-10-CM diagnosis codes across 1 article. The most cited include J95.00 (Unspecified tracheostomy complication), J95.01 (Hemorrhage from tracheostomy stoma), J95.02 (Infection of tracheostomy stoma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for A4605 change in 2026?
The average non-rural state fee for NU moved from $23.00 in 2025 to $23.47 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4605 can be billed per day?
90 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related A46 codes
- A4600 — Sleeve for intermittent limb compression device, replacement only, each
- A4601 — Lithium ion battery, rechargeable, for non-prosthetic use, replacement
- A4602 — Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each ($5.31–$6.33)
- A4604 — Tubing with integrated heating element for use with positive airway pressure device ($49.31–$76.79)
- A4606 — Oxygen probe for use with oximeter device, replacement
- A4608 — Transtracheal oxygen catheter, each ($71.44–$85.73)
- A4611 — Battery, heavy duty; replacement for patient owned ventilator
- A4612 — Battery cables; replacement for patient-owned ventilator
- A4613 — Battery charger; replacement for patient-owned ventilator
- A4614 — Peak expiratory flow rate meter, hand held ($33.89–$40.68)
- A4615 — Cannula, nasal ($1.04–$1.25)
- A4616 — Tubing (oxygen), per foot ($0.08–$0.10)
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 A4605
- Watch A4605 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4605
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.