A4635 HCPCS code: Underarm pad, crutch, replacement, each

A4635 is the HCPCS Level II code for underarm pad, crutch, replacement, each. The 2026 Medicare DMEPOS fee schedule pays $6.19 to $15.36 (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 2 per day on DME suppliers. Its average fee ranks 7 of 13 A46 codes billed NU (family range $2.30–$66.87).

Code details

2026 Medicare DMEPOS fee schedule for A4635

How the A4635 fee compares

NCCI unit limits (MUE)

What changed for A4635

• 2026-01-01: Average state fee (NU) rose 2.0%: $6.95 to $7.09
• 2026-01-01: Average state fee (RR) rose 2.2%: $0.94 to $0.96
• 2026-01-01: Average state fee (UE) rose 2.0%: $4.73 to $4.82
• 1991-01-01: A4635 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 A4635?

A4635 is the HCPCS Level II code for underarm pad, crutch, replacement, each. Short descriptor: "Underarm crutch pad".

How much does Medicare pay for A4635?

Under the 2026 DMEPOS fee schedule, non-rural state fees are NU (new equipment, purchased): $6.19–$15.36; RR (rental (monthly)): $0.84–$1.48; UE (used equipment, purchased): $4.13–$11.51. Rural fees can be higher.

Does Medicare cover A4635?

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

Did the Medicare fee for A4635 change in 2026?

The average non-rural state fee for NU moved from $6.95 in 2025 to $7.09 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of A4635 can be billed per day?

2 on DME suppliers (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)

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Next steps

• Run a reimbursement report for a device billed under A4635
• Watch A4635 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A4635

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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