A5122 HCPCS code: Skin barrier; solid, 8 x 8 or equivalent, each
A5122 is the HCPCS Level II code for skin barrier; solid, 8 x 8 or equivalent, each. The 2026 Medicare DMEPOS fee schedule pays $15.56 to $21.69 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 33% from 2022 to 2024 (7,760 to 10,326 services). In 2024, 65 suppliers billed Medicare for A5122 (purchases), serving 201 beneficiaries; New York, California, Massachusetts accounted for 32% of services. Its average fee ranks 5 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 A5122
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $15.56 | $21.69 | $18.30 | $15.56 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $20.26 | — |
| AL | — | $18.19 | — |
| AR | — | $18.30 | — |
| AZ | — | $18.30 | — |
| CA | — | $18.30 | — |
| CO | — | $18.30 | — |
| CT | — | $18.30 | — |
| DC | — | $15.56 | — |
| DE | — | $15.56 | — |
| FL | — | $18.30 | — |
| GA | — | $18.30 | — |
| HI | — | $21.69 | — |
| IA | — | $18.30 | — |
| ID | — | $15.56 | — |
| IL | — | $18.30 | — |
| IN | — | $17.43 | — |
| KS | — | $18.30 | — |
| KY | — | $18.30 | — |
| LA | — | $18.30 | — |
| MA | — | $15.56 | — |
| MD | — | $15.90 | — |
| ME | — | $15.56 | — |
| MI | — | $18.30 | — |
| MN | — | $17.67 | — |
| MO | — | $18.30 | — |
| MS | — | $18.30 | — |
| MT | — | $15.56 | — |
| NC | — | $17.89 | — |
| ND | — | $18.30 | — |
| NE | — | $18.30 | — |
| NH | — | $15.56 | — |
| NJ | — | $15.56 | — |
| NM | — | $18.30 | — |
| NV | — | $18.30 | — |
| NY | — | $16.25 | — |
| OH | — | $18.30 | — |
| OK | — | $18.30 | — |
| OR | — | $15.56 | — |
| PA | — | $15.56 | — |
| PR | — | $20.17 | — |
| RI | — | $15.56 | — |
| SC | — | $18.30 | — |
| SD | — | $18.30 | — |
| TN | — | $15.56 | — |
| TX | — | $15.56 | — |
| UT | — | $18.24 | — |
| VA | — | $15.56 | — |
| VI | — | $16.25 | — |
| VT | — | $15.56 | — |
| WA | — | $17.43 | — |
| WI | — | $18.01 | — |
| WV | — | $18.30 | — |
| WY | — | $18.30 | — |
How the A5122 fee compares
| Measure | Value |
|---|---|
| Rank among 9 A51 codes (lowest = 1) | 5 |
| Family fee range (average of state fees) | $1.77–$56.11 |
| Rural fee uplift | — |
Who bills A5122 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 65 |
| Referring clinicians | 212 |
| Medicare beneficiaries | 201 |
| States with claims | 19 |
| Share of services in top 3 states (New York, California, Massachusetts) | 32% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 62 | 197 |
| 2023 | 59 | 221 |
| 2024 | 65 | 201 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A5122, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 7,760 | 197 | $14.72 | $11.35 |
| 2023 | 9,378 | 221 | $15.87 | $12.27 |
| 2024 | 10,326 | 201 | $16.41 | $12.68 |
States with the most A5122 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 1,198 | $11.97 |
| California | 824 | $13.68 |
| Massachusetts | 817 | $11.31 |
| Texas | 667 | $11.61 |
| South Carolina | 656 | $13.74 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: Data |
What changed for A5122
- 2026-01-01: Average state fee rose 2.0%: $17.13 to $17.48
- 1990-01-01: A5122 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 A5122?
A5122 is the HCPCS Level II code for skin barrier; solid, 8 x 8 or equivalent, each. Short descriptor: "Solid skin barrier 8x8".
How much does Medicare pay for A5122?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $15.56–$21.69. Rural fees can be higher.
Does Medicare cover A5122?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A5122 change in 2026?
The average non-rural state fee moved from $17.13 in 2025 to $17.48 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A5122 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)
- A5121 — Skin barrier; solid, 6 x 6 or equivalent, each ($5.90–$12.99)
- 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 A5122
- Watch A5122 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A5122
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.