A4623 HCPCS code: Tracheostomy, inner cannula
A4623 is the HCPCS Level II code for tracheostomy, inner cannula. The 2026 Medicare DMEPOS fee schedule pays $4.35 to $9.34 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 200 per day on DME suppliers. Medicare volume rose 2% from 2022 to 2024 (1,955,546 to 1,996,086 services). In 2024, 1,448 suppliers billed Medicare for A4623 (purchases), serving 8,855 beneficiaries; New York, California, Pennsylvania accounted for 34% of services. Its average fee ranks 7 of 10 A46 codes (family range $0.08–$71.71).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 37 — DMEPOS: ostomy, tracheostomy and urological supplies |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 1990-01-01 |
| Last action effective | 2004-01-01 |
2026 Medicare DMEPOS fee schedule for A4623
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $4.35 | $9.34 | $9.34 | $7.94 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $4.90 | — |
| AL | — | $7.94 | — |
| AR | — | $9.34 | — |
| AZ | — | $7.94 | — |
| CA | — | $7.94 | — |
| CO | — | $9.34 | — |
| CT | — | $9.34 | — |
| DC | — | $9.34 | — |
| DE | — | $9.34 | — |
| FL | — | $9.34 | — |
| GA | — | $8.91 | — |
| HI | — | $5.18 | — |
| IA | — | $7.94 | — |
| ID | — | $7.94 | — |
| IL | — | $7.94 | — |
| IN | — | $9.34 | — |
| KS | — | $7.94 | — |
| KY | — | $7.94 | — |
| LA | — | $9.34 | — |
| MA | — | $9.34 | — |
| MD | — | $9.34 | — |
| ME | — | $9.34 | — |
| MI | — | $9.34 | — |
| MN | — | $9.34 | — |
| MO | — | $8.42 | — |
| MS | — | $7.94 | — |
| MT | — | $9.34 | — |
| NC | — | $7.94 | — |
| ND | — | $9.34 | — |
| NE | — | $7.94 | — |
| NH | — | $9.34 | — |
| NJ | — | $9.34 | — |
| NM | — | $7.94 | — |
| NV | — | $7.94 | — |
| NY | — | $9.34 | — |
| OH | — | $7.94 | — |
| OK | — | $7.94 | — |
| OR | — | $7.94 | — |
| PA | — | $9.34 | — |
| PR | — | $4.35 | — |
| RI | — | $8.44 | — |
| SC | — | $7.94 | — |
| SD | — | $9.34 | — |
| TN | — | $7.94 | — |
| TX | — | $7.95 | — |
| UT | — | $7.94 | — |
| VA | — | $9.34 | — |
| VI | — | $9.34 | — |
| VT | — | $9.34 | — |
| WA | — | $9.34 | — |
| WI | — | $9.34 | — |
| WV | — | $7.94 | — |
| WY | — | $9.34 | — |
How the A4623 fee compares
| Measure | Value |
|---|---|
| Rank among 10 A46 codes (lowest = 1) | 7 |
| Family fee range (average of state fees) | $0.08–$71.71 |
| Rural fee uplift | — |
Who bills A4623 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 1,448 |
| Referring clinicians | 6,770 |
| Medicare beneficiaries | 8,855 |
| States with claims | 51 |
| Share of services in top 3 states (New York, California, Pennsylvania) | 34% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 1,434 | 8,926 |
| 2023 | 1,447 | 8,862 |
| 2024 | 1,448 | 8,855 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4623, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,955,546 | 8,926 | $7.51 | $5.85 |
| 2023 | 1,997,242 | 8,862 | $8.15 | $6.31 |
| 2024 | 1,996,086 | 8,855 | $8.27 | $6.40 |
States with the most A4623 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 330,908 | $6.91 |
| California | 208,024 | $5.89 |
| Pennsylvania | 144,924 | $6.84 |
| Texas | 118,797 | $5.88 |
| New Jersey | 110,429 | $6.94 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 200 | Published Contractor Policy |
| outpatient hospital claims | 10 | Clinical: Data |
What changed for A4623
- 2026-01-01: Average state fee rose 2.0%: $8.32 to $8.49
- 1990-01-01: A4623 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 A4623?
A4623 is the HCPCS Level II code for tracheostomy, inner cannula. Short descriptor: "Tracheostomy inner cannula".
How much does Medicare pay for A4623?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $4.35–$9.34. Rural fees can be higher.
Does Medicare cover A4623?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A4623 change in 2026?
The average non-rural state fee moved from $8.32 in 2025 to $8.49 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A4623 can be billed per day?
200 on DME suppliers; 10 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)
- 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 A4623
- Watch A4623 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4623
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.