A5113 HCPCS code: Leg strap; latex, replacement only, per set
A5113 is the HCPCS Level II code for leg strap; latex, replacement only, per set. The 2026 Medicare DMEPOS fee schedule pays $4.96 to $8.91 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 3 per day on DME suppliers. Its average fee ranks 2 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 | 1998-01-01 |
2026 Medicare DMEPOS fee schedule for A5113
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $4.96 | $8.91 | $6.71 | $5.70 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $4.96 | — |
| AL | — | $5.70 | — |
| AR | — | $6.71 | — |
| AZ | — | $6.71 | — |
| CA | — | $5.70 | — |
| CO | — | $6.71 | — |
| CT | — | $5.70 | — |
| DC | — | $6.71 | — |
| DE | — | $6.71 | — |
| FL | — | $6.71 | — |
| GA | — | $6.71 | — |
| HI | — | $5.31 | — |
| IA | — | $6.71 | — |
| ID | — | $5.70 | — |
| IL | — | $6.71 | — |
| IN | — | $5.70 | — |
| KS | — | $6.71 | — |
| KY | — | $5.70 | — |
| LA | — | $6.71 | — |
| MA | — | $6.38 | — |
| MD | — | $6.71 | — |
| ME | — | $6.38 | — |
| MI | — | $6.71 | — |
| MN | — | $6.71 | — |
| MO | — | $6.71 | — |
| MS | — | $6.71 | — |
| MT | — | $5.70 | — |
| NC | — | $5.70 | — |
| ND | — | $5.70 | — |
| NE | — | $6.71 | — |
| NH | — | $6.38 | — |
| NJ | — | $6.71 | — |
| NM | — | $5.70 | — |
| NV | — | $6.71 | — |
| NY | — | $6.71 | — |
| OH | — | $5.70 | — |
| OK | — | $5.70 | — |
| OR | — | $5.70 | — |
| PA | — | $6.71 | — |
| PR | — | $8.91 | — |
| RI | — | $5.70 | — |
| SC | — | $6.71 | — |
| SD | — | $5.70 | — |
| TN | — | $5.70 | — |
| TX | — | $5.70 | — |
| UT | — | $5.70 | — |
| VA | — | $6.71 | — |
| VI | — | $6.71 | — |
| VT | — | $6.38 | — |
| WA | — | $6.71 | — |
| WI | — | $6.71 | — |
| WV | — | $5.70 | — |
| WY | — | $5.70 | — |
How the A5113 fee compares
| Measure | Value |
|---|---|
| Rank among 9 A51 codes (lowest = 1) | 2 |
| Family fee range (average of state fees) | $1.77–$56.11 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 3 | 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 A5113
- 2026-01-01: Average state fee rose 2.0%: $6.16 to $6.29
- 1990-01-01: A5113 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 A5113?
A5113 is the HCPCS Level II code for leg strap; latex, replacement only, per set. Short descriptor: "Latex leg strap".
How much does Medicare pay for A5113?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $4.96–$8.91. Rural fees can be higher.
Does Medicare cover A5113?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for A5113?
Medicare policy articles that cite A5113 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 A5113 change in 2026?
The average non-rural state fee moved from $6.16 in 2025 to $6.29 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A5113 can be billed per day?
3 on DME suppliers (NCCI medically unlikely edits).
Related A51 codes
- A5102 — Bedside drainage bottle with or without tubing, rigid or expandable, each ($27.85–$35.14)
- A5105 — Urinary suspensory with leg bag, with or without tube, each ($28.84–$91.13)
- A5112 — Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each ($41.95–$61.74)
- 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 A5113
- Watch A5113 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A5113
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.