A4618 HCPCS code: Breathing circuits

A4618 is the HCPCS Level II code for breathing circuits. The 2026 Medicare DMEPOS fee schedule pays $10.78 to $31.06 (NU, new equipment, purchased) depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 12 per day on DME suppliers. Medicare volume fell 83% from 2022 to 2024 (421 to 72 services). In 2024, 19 suppliers billed Medicare for A4618 (purchases), serving 22 beneficiaries. Its average fee ranks 9 of 13 A46 codes billed NU (family range $2.30–$66.87).

Code details

2026 Medicare DMEPOS fee schedule for A4618

How the A4618 fee compares

Who bills A4618 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for A4618, 2022–2024

NCCI unit limits (MUE)

What changed for A4618

• 2026-01-01: Average state fee (NU) rose 2.0%: $12.47 to $12.72
• 2026-01-01: Average state fee (RR) rose 2.2%: $1.40 to $1.43
• 2026-01-01: Average state fee (UE) rose 2.0%: $9.35 to $9.54
• 1990-01-01: A4618 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 A4618?

A4618 is the HCPCS Level II code for breathing circuits. Short descriptor: "Breathing circuits".

How much does Medicare pay for A4618?

Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $10.78–$31.06; RR (rental (monthly)): $1.25–$3.11; UE (used equipment, purchased): $8.08–$23.31. Rural fees can be higher.

Does Medicare cover A4618?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Did the Medicare fee for A4618 change in 2026?

The average non-rural state fee for NU moved from $12.47 in 2025 to $12.72 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4618 can be billed per day?

12 on DME suppliers; 1 on outpatient hospital claims; 1 on practitioner 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)
• A4605 — Tracheal suction catheter, closed system, each ($23.31–$27.99)
• 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)

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 A4618
• Watch A4618 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4618

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.

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