A4928 HCPCS code: Surgical mask, per 20
A4928 is the HCPCS Level II code for surgical mask, per 20. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | P9B |
| Added | 2002-01-01 |
| Last action effective | 2015-01-01 |
What changed for A4928
- 2002-01-01: A4928 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 A4928?
A4928 is the HCPCS Level II code for surgical mask, per 20. Short descriptor: "Surgical mask".
Does Medicare cover A4928?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Related A49 codes
- A4911 — Drain bag/bottle, for dialysis, each
- A4913 — Miscellaneous dialysis supplies, not otherwise specified
- A4918 — Venous pressure clamp, for hemodialysis, each
- A4927 — Gloves, non-sterile, per 100
- A4929 — Tourniquet for dialysis, each
- A4930 — Gloves, sterile, per pair
- A4931 — Oral thermometer, reusable, any type, each
- A4932 — Rectal thermometer, reusable, any type, each
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Next steps
- Run a reimbursement report for a device billed under A4928
- Watch A4928 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4928
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.