A7040 HCPCS code: One way chest drain valve
A7040 is the HCPCS Level II code for one way chest drain valve. The 2026 Medicare DMEPOS fee schedule pays $56.24 to $58.41 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on outpatient hospital claims. Its average fee ranks 2 of 4 A70 codes (family range $0.41–$107.55).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 38 — DMEPOS: orthotics, prosthetics, prosthetic devices and vision services |
| BETOS category | D1F — Prosthetic and orthotic devices |
| Added | 2005-01-01 |
| Last action effective | 2005-01-01 |
2026 Medicare DMEPOS fee schedule for A7040
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $56.24 | $58.41 | $68.67 | $51.50 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AL | — | $57.96 | — |
| AR | — | $57.96 | — |
| AZ | — | $56.24 | — |
| CA | — | $56.24 | — |
| CO | — | $58.41 | — |
| CT | — | $56.24 | — |
| DC | — | $56.24 | — |
| DE | — | $56.24 | — |
| FL | — | $57.96 | — |
| GA | — | $57.96 | — |
| IA | — | $57.36 | — |
| ID | — | $56.24 | — |
| IL | — | $57.63 | — |
| IN | — | $57.63 | — |
| KS | — | $57.36 | — |
| KY | — | $57.96 | — |
| LA | — | $57.96 | — |
| MA | — | $56.24 | — |
| MD | — | $56.24 | — |
| ME | — | $56.24 | — |
| MI | — | $57.63 | — |
| MN | — | $57.63 | — |
| MO | — | $57.36 | — |
| MS | — | $57.96 | — |
| MT | — | $58.41 | — |
| NC | — | $57.96 | — |
| ND | — | $58.41 | — |
| NE | — | $57.36 | — |
| NH | — | $56.24 | — |
| NJ | — | $56.24 | — |
| NM | — | $57.96 | — |
| NV | — | $56.24 | — |
| NY | — | $56.24 | — |
| OH | — | $57.63 | — |
| OK | — | $57.96 | — |
| OR | — | $56.24 | — |
| PA | — | $56.24 | — |
| RI | — | $56.24 | — |
| SC | — | $57.96 | — |
| SD | — | $58.41 | — |
| TN | — | $57.96 | — |
| TX | — | $57.96 | — |
| UT | — | $58.41 | — |
| VA | — | $56.24 | — |
| VT | — | $56.24 | — |
| WA | — | $56.24 | — |
| WI | — | $57.63 | — |
| WV | — | $56.24 | — |
| WY | — | $58.41 | — |
How the A7040 fee compares
| Measure | Value |
|---|---|
| Rank among 4 A70 codes (lowest = 1) | 2 |
| Family fee range (average of state fees) | $0.41–$107.55 |
| Rural fee uplift | — |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Clinical: CMS Workgroup |
| practitioner claims | 2 | Clinical: CMS Workgroup |
What changed for A7040
- 2026-01-01: Average state fee rose 2.0%: $56.10 to $57.22
- 2005-01-01: A7040 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 A7040?
A7040 is the HCPCS Level II code for one way chest drain valve. Short descriptor: "One way chest drain valve".
How much does Medicare pay for A7040?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $56.24–$58.41. Rural fees can be higher.
Does Medicare cover A7040?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A7040 change in 2026?
The average non-rural state fee moved from $56.10 in 2025 to $57.22 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A7040 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related A70 codes
- A7000 — Canister, disposable, used with suction pump, each ($9.24–$13.39)
- A7001 — Canister, non-disposable, used with suction pump, each ($40.06–$47.58)
- A7002 — Tubing, used with suction pump, each ($3.87–$5.47)
- A7003 — Administration set, with small volume nonfiltered pneumatic nebulizer, disposable ($1.86–$3.26)
- A7004 — Small volume nonfiltered pneumatic nebulizer, disposable ($1.51–$2.08)
- A7005 — Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable ($11.77–$29.20)
- A7006 — Administration set, with small volume filtered pneumatic nebulizer ($8.19–$14.94)
- A7007 — Large volume nebulizer, disposable, unfilled, used with aerosol compressor ($3.47–$5.87)
- A7008 — Large volume nebulizer, disposable, prefilled, used with aerosol compressor ($12.46–$18.09)
- A7009 — Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer ($54.00–$66.77)
- A7010 — Corrugated tubing, disposable, used with large volume nebulizer, 100 feet ($17.61–$27.19)
- A7011 — Corrugated tubing, non-disposable, used with large volume nebulizer, 10 feet
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Next steps
- Run a reimbursement report for a device billed under A7040
- Watch A7040 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7040
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.