A4648 HCPCS code: Tissue marker, implantable, any type, each
A4648 is the HCPCS Level II code for tissue marker, implantable, any type, each. In 2024 Medicare paid an average of $168.71 per service for A4648 across 16,810 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 3 per day on outpatient hospital claims. Medicare volume fell 8% from 2022 to 2024 (18,320 to 16,810 services). In 2024, about 915 clinicians billed Medicare for A4648 for 6,733 beneficiaries; New York, California, Illinois accounted for 39% of services.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 57 |
| BETOS category | I1E |
| Added | 2008-01-01 |
| Last action effective | 2008-01-01 |
Who bills A4648 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 915 |
| Medicare beneficiaries | 6,733 |
| States with claims | 39 |
| Share of services in top 3 states (New York, California, Illinois) | 39% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A4648, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 18,320 | 7,664 | $181.97 | $145.16 |
| 2023 | 17,193 | 6,897 | $188.93 | $150.47 |
| 2024 | 16,810 | 6,733 | $211.89 | $168.71 |
States with the most A4648 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 2,720 | $112.46 |
| California | 1,966 | $99.26 |
| Illinois | 1,799 | $184.54 |
| Florida | 1,036 | $182.05 |
| Arizona | 887 | $187.14 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3 | Clinical: Data |
| practitioner claims | 5 | Clinical: Data |
What changed for A4648
- 2008-01-01: A4648 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 A4648?
A4648 is the HCPCS Level II code for tissue marker, implantable, any type, each. Short descriptor: "Implantable tissue marker".
How much does Medicare pay for A4648?
In 2024, the average Medicare payment was $168.71 per service (average allowed $211.89).
Does Medicare cover A4648?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A4648 can be billed per day?
3 on outpatient hospital claims; 5 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 A4648
- Watch A4648 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4648
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; 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.