A5105 HCPCS code: Urinary suspensory with leg bag, with or without tube, each
A5105 is the HCPCS Level II code for urinary suspensory with leg bag, with or without tube, each. The 2026 Medicare DMEPOS fee schedule pays $28.84 to $91.13 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 4 per day on DME suppliers. Medicare volume fell 14% from 2022 to 2024 (735 to 631 services). In 2024, 55 suppliers billed Medicare for A5105 (purchases), serving 123 beneficiaries; Washington, California, Idaho accounted for 38% of services. Its average fee ranks 9 of 9 A51 codes (family range $1.77–$56.11).
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 | 2008-01-01 |
2026 Medicare DMEPOS fee schedule for A5105
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $28.84 | $91.13 | $58.11 | $49.39 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $85.21 | — |
| AL | — | $49.39 | — |
| AR | — | $54.50 | — |
| AZ | — | $58.11 | — |
| CA | — | $58.11 | — |
| CO | — | $51.40 | — |
| CT | — | $58.11 | — |
| DC | — | $58.11 | — |
| DE | — | $58.11 | — |
| FL | — | $49.39 | — |
| GA | — | $58.11 | — |
| HI | — | $91.13 | — |
| IA | — | $58.11 | — |
| ID | — | $58.11 | — |
| IL | — | $58.11 | — |
| IN | — | $58.11 | — |
| KS | — | $49.39 | — |
| KY | — | $50.60 | — |
| LA | — | $56.00 | — |
| MA | — | $49.39 | — |
| MD | — | $58.11 | — |
| ME | — | $49.39 | — |
| MI | — | $58.11 | — |
| MN | — | $58.11 | — |
| MO | — | $55.20 | — |
| MS | — | $58.11 | — |
| MT | — | $56.08 | — |
| NC | — | $58.11 | — |
| ND | — | $57.79 | — |
| NE | — | $49.39 | — |
| NH | — | $49.39 | — |
| NJ | — | $58.11 | — |
| NM | — | $54.50 | — |
| NV | — | $58.11 | — |
| NY | — | $58.11 | — |
| OH | — | $58.11 | — |
| OK | — | $54.50 | — |
| OR | — | $49.39 | — |
| PA | — | $58.11 | — |
| PR | — | $28.84 | — |
| RI | — | $58.11 | — |
| SC | — | $49.39 | — |
| SD | — | $55.34 | — |
| TN | — | $58.11 | — |
| TX | — | $58.11 | — |
| UT | — | $52.87 | — |
| VA | — | $49.39 | — |
| VI | — | $58.11 | — |
| VT | — | $49.39 | — |
| WA | — | $58.11 | — |
| WI | — | $58.11 | — |
| WV | — | $58.11 | — |
| WY | — | $57.79 | — |
How the A5105 fee compares
| Measure | Value |
|---|---|
| Rank among 9 A51 codes (lowest = 1) | 9 |
| Family fee range (average of state fees) | $1.77–$56.11 |
| Rural fee uplift | — |
Who bills A5105 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 55 |
| Referring clinicians | 121 |
| Medicare beneficiaries | 123 |
| States with claims | 16 |
| Share of services in top 3 states (Washington, California, Idaho) | 38% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 67 | 186 |
| 2023 | 70 | 158 |
| 2024 | 55 | 123 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A5105, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 735 | 186 | $39.55 | $29.32 |
| 2023 | 648 | 158 | $41.85 | $31.22 |
| 2024 | 631 | 123 | $45.36 | $33.62 |
States with the most A5105 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Washington | 76 | $20.30 |
| California | 71 | $39.51 |
| Idaho | 34 | $20.74 |
| New York | 34 | $36.53 |
| Maryland | 32 | $40.03 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 4 | Clinical: Data |
| outpatient hospital claims | 1 | Clinical: Data |
Medicare policy articles for this code
- A52521: Urological Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (1 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| N39.3 | Stress incontinence (female) (male) | 1 |
What changed for A5105
- 2026-01-01: Average state fee rose 2.0%: $55.01 to $56.11
- 1990-01-01: A5105 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 A5105?
A5105 is the HCPCS Level II code for urinary suspensory with leg bag, with or without tube, each. Short descriptor: "Urinary suspensory".
How much does Medicare pay for A5105?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $28.84–$91.13. Rural fees can be higher.
Does Medicare cover A5105?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for A5105?
Medicare policy articles that cite A5105 list 1 covered ICD-10-CM diagnosis codes across 1 article. The most cited include N39.3 (Stress incontinence (female) (male)). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Did the Medicare fee for A5105 change in 2026?
The average non-rural state fee moved from $55.01 in 2025 to $56.11 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A5105 can be billed per day?
4 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related A51 codes
- A5102 — Bedside drainage bottle with or without tubing, rigid or expandable, each ($27.85–$35.14)
- A5112 — Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each ($41.95–$61.74)
- A5113 — Leg strap; latex, replacement only, per set ($4.96–$8.91)
- A5114 — Leg strap; foam or fabric, replacement only, per set ($8.91–$26.83)
- A5120 — Skin barrier, wipes or swabs, each ($0.14–$0.39)
- A5121 — Skin barrier; solid, 6 x 6 or equivalent, each ($5.90–$12.99)
- A5122 — Skin barrier; solid, 8 x 8 or equivalent, each ($15.56–$21.69)
- A5126 — Adhesive or non-adhesive; disk or foam pad ($1.56–$2.56)
- A5131 — Appliance cleaner, incontinence and ostomy appliances, per 16 oz. ($19.20–$72.12)
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Next steps
- Run a reimbursement report for a device billed under A5105
- Watch A5105 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A5105
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.