K0455 HCPCS code: Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)

K0455 is the HCPCS Level II code for infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol). The 2026 Medicare DMEPOS fee schedule pays $320.84 to $483.38 (RR, rental (monthly)) 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 DME suppliers. Medicare volume fell 12% from 2022 to 2024 (10,971 to 9,627 services). In 2024, 33 suppliers billed Medicare for K0455 (rentals), serving 1,150 beneficiaries; California, Texas, Florida accounted for 22% of services.

Code details

2026 Medicare DMEPOS fee schedule for K0455

How the K0455 fee compares

Who bills K0455 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for K0455, 2022–2024

States with the most K0455 services (2024)

NCCI unit limits (MUE)

Medicare policy articles for this code

• A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (460 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

Showing 10 of 460. The full list, non-covered diagnoses and CSV export are in Caduvo.

What changed for K0455

• 2026-01-01: Average state fee (RR) rose 2.0%: $358.69 to $365.87
• 1998-01-01: K0455 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 K0455?

K0455 is the HCPCS Level II code for infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol). Short descriptor: "Pump uninterrupted infusion".

How much does Medicare pay for K0455?

Under the 2026 DMEPOS fee schedule, non-rural state fees are RR (rental (monthly)): $320.84–$483.38. Rural fees can be higher.

Does Medicare cover K0455?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Which diagnoses support coverage for K0455?

Medicare policy articles that cite K0455 list 460 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C91.00 (Acute lymphoblastic leukemia not having achieved remission), C91.01 (Acute lymphoblastic leukemia, in remission), C91.02 (Acute lymphoblastic leukemia, in relapse). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for K0455 change in 2026?

The average non-rural state fee for RR moved from $358.69 in 2025 to $365.87 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

How many units of K0455 can be billed per day?

1 on DME suppliers (NCCI medically unlikely edits).

Related K04 codes

• K0462 — Temporary replacement for patient owned equipment being repaired, any type

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Next steps

• Run a reimbursement report for a device billed under K0455
• Watch K0455 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for K0455

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.

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