A5200 HCPCS code: Percutaneous catheter/tube anchoring device, adhesive skin attachment
A5200 is the HCPCS Level II code for percutaneous catheter/tube anchoring device, adhesive skin attachment. The 2026 Medicare DMEPOS fee schedule pays $16.10 to $19.36 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 2 per day on outpatient hospital claims. In 2024, 81 suppliers billed Medicare for A5200 (purchases), serving 405 beneficiaries; California, New Jersey, Georgia accounted for 46% of services.
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 | 1999-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for A5200
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $16.10 | $19.36 | $16.12 | $13.70 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $16.10 | — |
| AL | — | $16.12 | — |
| AR | — | $16.12 | — |
| AZ | — | $16.10 | — |
| CA | — | $16.10 | — |
| CO | — | $16.12 | — |
| CT | — | $16.12 | — |
| DC | — | $16.10 | — |
| DE | — | $16.12 | — |
| FL | — | $16.10 | — |
| GA | — | $16.12 | — |
| HI | — | $16.10 | — |
| IA | — | $16.10 | — |
| ID | — | $16.10 | — |
| IL | — | $16.10 | — |
| IN | — | $16.12 | — |
| KS | — | $16.10 | — |
| KY | — | $16.12 | — |
| LA | — | $16.12 | — |
| MA | — | $16.12 | — |
| MD | — | $16.10 | — |
| ME | — | $16.12 | — |
| MI | — | $16.12 | — |
| MN | — | $16.12 | — |
| MO | — | $16.12 | — |
| MS | — | $16.12 | — |
| MT | — | $16.10 | — |
| NC | — | $16.12 | — |
| ND | — | $16.10 | — |
| NE | — | $16.10 | — |
| NH | — | $16.12 | — |
| NJ | — | $16.12 | — |
| NM | — | $16.12 | — |
| NV | — | $16.10 | — |
| NY | — | $16.12 | — |
| OH | — | $16.10 | — |
| OK | — | $16.12 | — |
| OR | — | $16.10 | — |
| PA | — | $16.12 | — |
| PR | — | $19.36 | — |
| RI | — | $16.12 | — |
| SC | — | $16.12 | — |
| SD | — | $16.10 | — |
| TN | — | $16.12 | — |
| TX | — | $16.10 | — |
| UT | — | $16.12 | — |
| VA | — | $16.10 | — |
| VI | — | $16.12 | — |
| VT | — | $16.12 | — |
| WA | — | $16.10 | — |
| WI | — | $16.12 | — |
| WV | — | $16.10 | — |
| WY | — | $16.10 | — |
How the A5200 fee compares
| Measure | Value |
|---|---|
| Rank among 1 A52 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $16.17–$16.17 |
| Rural fee uplift | — |
Who bills A5200 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 81 |
| Referring clinicians | 306 |
| Medicare beneficiaries | 405 |
| States with claims | 23 |
| Share of services in top 3 states (California, New Jersey, Georgia) | 46% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 84 | 283 |
| 2023 | 84 | 307 |
| 2024 | 81 | 405 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A5200, 2022–2022
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 50 | 41 | $24.72 | $19.77 |
States with the most A5200 services (2022)
| State | Services | Avg. paid |
|---|---|---|
| North Carolina | 32 | $19.99 |
| Washington | 16 | $20.00 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: Data |
| practitioner claims | 2 | 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 A5200
- 2026-01-01: Average state fee rose 2.0%: $15.85 to $16.17
- 1999-01-01: A5200 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 A5200?
A5200 is the HCPCS Level II code for percutaneous catheter/tube anchoring device, adhesive skin attachment. Short descriptor: "Percutaneous catheter anchor".
How much does Medicare pay for A5200?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $16.10–$19.36. Rural fees can be higher.
Does Medicare cover A5200?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for A5200?
Medicare policy articles that cite A5200 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 A5200 change in 2026?
The average non-rural state fee moved from $15.85 in 2025 to $16.17 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A5200 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
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 A5200
- Watch A5200 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A5200
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.