A5121 HCPCS code: Skin barrier; solid, 6 x 6 or equivalent, each
A5121 is the HCPCS Level II code for skin barrier; solid, 6 x 6 or equivalent, each. The 2026 Medicare DMEPOS fee schedule pays $5.90 to $12.99 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 1 per day on outpatient hospital claims. Medicare volume rose 6% from 2022 to 2024 (708,251 to 748,543 services). In 2024, 399 suppliers billed Medicare for A5121 (purchases), serving 8,318 beneficiaries; Florida, Texas, California accounted for 22% of services. Its average fee ranks 3 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 | 1990-01-01 |
2026 Medicare DMEPOS fee schedule for A5121
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $5.90 | $12.99 | $10.62 | $9.03 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $12.11 | — |
| AL | — | $9.60 | — |
| AR | — | $10.62 | — |
| AZ | — | $9.03 | — |
| CA | — | $10.62 | — |
| CO | — | $10.62 | — |
| CT | — | $10.62 | — |
| DC | — | $9.33 | — |
| DE | — | $9.33 | — |
| FL | — | $9.03 | — |
| GA | — | $9.03 | — |
| HI | — | $12.99 | — |
| IA | — | $10.62 | — |
| ID | — | $9.03 | — |
| IL | — | $10.62 | — |
| IN | — | $10.02 | — |
| KS | — | $10.62 | — |
| KY | — | $10.62 | — |
| LA | — | $10.62 | — |
| MA | — | $10.55 | — |
| MD | — | $10.62 | — |
| ME | — | $10.55 | — |
| MI | — | $10.62 | — |
| MN | — | $9.99 | — |
| MO | — | $10.62 | — |
| MS | — | $10.62 | — |
| MT | — | $10.62 | — |
| NC | — | $10.62 | — |
| ND | — | $10.62 | — |
| NE | — | $10.62 | — |
| NH | — | $10.04 | — |
| NJ | — | $9.33 | — |
| NM | — | $10.62 | — |
| NV | — | $9.58 | — |
| NY | — | $9.03 | — |
| OH | — | $10.17 | — |
| OK | — | $10.62 | — |
| OR | — | $10.62 | — |
| PA | — | $9.33 | — |
| PR | — | $5.90 | — |
| RI | — | $10.62 | — |
| SC | — | $10.62 | — |
| SD | — | $10.62 | — |
| TN | — | $10.62 | — |
| TX | — | $10.17 | — |
| UT | — | $9.20 | — |
| VA | — | $9.03 | — |
| VI | — | $9.03 | — |
| VT | — | $10.47 | — |
| WA | — | $10.62 | — |
| WI | — | $9.65 | — |
| WV | — | $10.17 | — |
| WY | — | $10.62 | — |
How the A5121 fee compares
| Measure | Value |
|---|---|
| Rank among 9 A51 codes (lowest = 1) | 3 |
| Family fee range (average of state fees) | $1.77–$56.11 |
| Rural fee uplift | — |
Who bills A5121 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 399 |
| Referring clinicians | 7,270 |
| Medicare beneficiaries | 8,318 |
| States with claims | 51 |
| Share of services in top 3 states (Florida, Texas, California) | 22% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 418 | 8,085 |
| 2023 | 411 | 8,139 |
| 2024 | 399 | 8,318 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A5121, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 708,251 | 8,085 | $8.51 | $6.59 |
| 2023 | 717,962 | 8,139 | $9.24 | $7.12 |
| 2024 | 748,543 | 8,318 | $9.48 | $7.30 |
States with the most A5121 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 63,639 | $6.75 |
| Texas | 52,348 | $7.36 |
| California | 51,089 | $7.71 |
| New York | 49,492 | $6.68 |
| Massachusetts | 33,526 | $7.71 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
What changed for A5121
- 2026-01-01: Average state fee rose 2.0%: $9.95 to $10.15
- 1990-01-01: A5121 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 A5121?
A5121 is the HCPCS Level II code for skin barrier; solid, 6 x 6 or equivalent, each. Short descriptor: "Solid skin barrier 6x6".
How much does Medicare pay for A5121?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $5.90–$12.99. Rural fees can be higher.
Does Medicare cover A5121?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A5121 change in 2026?
The average non-rural state fee moved from $9.95 in 2025 to $10.15 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A5121 can be billed per day?
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)
- 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)
- 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)
- 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)
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 A5121
- Watch A5121 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A5121
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.