K0552 HCPCS code: Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each
K0552 is the HCPCS Level II code for supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each. The 2026 Medicare DMEPOS fee schedule pays $3.47 to $3.96 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. Medicare volume fell 6% from 2022 to 2024 (394,347 to 369,364 services). In 2024, 372 suppliers billed Medicare for K0552 (purchases), serving 7,799 beneficiaries; Florida, California, Texas accounted for 26% of services.
Code details
| Field | Value |
|---|---|
| Section | K codes — Temporary codes for DME MACs |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 34 — DMEPOS: supplies necessary for the effective use of DME |
| BETOS category | D1E — Other durable medical equipment |
| Added | 2003-07-01 |
| Last action effective | 2017-01-01 |
2026 Medicare DMEPOS fee schedule for K0552
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $3.47 | $3.96 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $3.60 | — |
| AL | — | $3.47 | $3.62 |
| AR | — | $3.47 | $3.62 |
| AZ | — | $3.47 | $3.60 |
| CA | — | $3.47 | $3.60 |
| CO | — | $3.47 | $3.62 |
| CT | — | $3.47 | $3.62 |
| DC | — | $3.47 | $3.60 |
| DE | — | $3.47 | $3.62 |
| FL | — | $3.47 | $3.60 |
| GA | — | $3.47 | $3.62 |
| HI | — | $3.60 | — |
| IA | — | $3.47 | $3.60 |
| ID | — | $3.47 | $3.60 |
| IL | — | $3.47 | $3.60 |
| IN | — | $3.47 | $3.62 |
| KS | — | $3.47 | $3.60 |
| KY | — | $3.47 | $3.62 |
| LA | — | $3.47 | $3.62 |
| MA | — | $3.47 | $3.62 |
| MD | — | $3.47 | $3.60 |
| ME | — | $3.47 | $3.62 |
| MI | — | $3.47 | $3.62 |
| MN | — | $3.47 | $3.62 |
| MO | — | $3.47 | $3.62 |
| MS | — | $3.47 | $3.62 |
| MT | — | $3.47 | $3.60 |
| NC | — | $3.47 | $3.60 |
| ND | — | $3.47 | $3.60 |
| NE | — | $3.47 | $3.60 |
| NH | — | $3.47 | $3.62 |
| NJ | — | $3.47 | $3.62 |
| NM | — | $3.47 | $3.62 |
| NV | — | $3.47 | $3.60 |
| NY | — | $3.47 | $3.62 |
| OH | — | $3.47 | $3.60 |
| OK | — | $3.47 | $3.62 |
| OR | — | $3.47 | $3.60 |
| PA | — | $3.47 | $3.62 |
| PR | — | $3.96 | — |
| RI | — | $3.47 | $3.62 |
| SC | — | $3.47 | $3.62 |
| SD | — | $3.47 | $3.60 |
| TN | — | $3.47 | $3.62 |
| TX | — | $3.47 | $3.60 |
| UT | — | $3.47 | $3.62 |
| VA | — | $3.47 | $3.60 |
| VI | — | $3.62 | — |
| VT | — | $3.47 | $3.62 |
| WA | — | $3.47 | $3.60 |
| WI | — | $3.47 | $3.62 |
| WV | — | $3.47 | $3.60 |
| WY | — | $3.47 | $3.60 |
How the K0552 fee compares
| Measure | Value |
|---|---|
| Rank among 1 K05 codes (lowest = 1) | 1 |
| Family fee range (average of state fees) | $3.49–$3.49 |
| Rural fee uplift | 3.6% |
Who bills K0552 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 372 |
| Referring clinicians | 3,048 |
| Medicare beneficiaries | 7,799 |
| States with claims | 51 |
| Share of services in top 3 states (Florida, California, Texas) | 26% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 403 | 7,440 |
| 2023 | 357 | 7,483 |
| 2024 | 372 | 7,799 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for K0552, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 394,347 | 7,440 | $3.01 | $2.37 |
| 2023 | 379,390 | 7,483 | $3.27 | $2.56 |
| 2024 | 369,364 | 7,799 | $3.30 | $2.58 |
States with the most K0552 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 43,367 | $2.56 |
| California | 33,494 | $2.57 |
| Texas | 20,999 | $2.57 |
| Georgia | 19,365 | $2.55 |
| Massachusetts | 15,404 | $2.56 |
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:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C91.00 | Acute lymphoblastic leukemia not having achieved remission | 1 |
| C91.01 | Acute lymphoblastic leukemia, in remission | 1 |
| C91.02 | Acute lymphoblastic leukemia, in relapse | 1 |
| D80.0 | Hereditary hypogammaglobulinemia | 1 |
| D80.2 | Selective deficiency of immunoglobulin A [IgA] | 1 |
| D80.3 | Selective deficiency of immunoglobulin G [IgG] subclasses | 1 |
| D80.4 | Selective deficiency of immunoglobulin M [IgM] | 1 |
| D80.5 | Immunodeficiency with increased immunoglobulin M [IgM] | 1 |
| D80.6 | Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia | 1 |
| D80.7 | Transient hypogammaglobulinemia of infancy | 1 |
Showing 10 of 460. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for K0552
- 2026-01-01: Average state fee rose 2.6%: $3.40 to $3.49
- 2003-07-01: K0552 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 K0552?
K0552 is the HCPCS Level II code for supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each. Short descriptor: "Sup/ext non-ins inf pump syr".
How much does Medicare pay for K0552?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $3.47–$3.96. Rural fees can be higher.
Does Medicare cover K0552?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for K0552?
Medicare policy articles that cite K0552 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 K0552 change in 2026?
The average non-rural state fee moved from $3.40 in 2025 to $3.49 in 2026 (+2.6%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
Related K05 codes
- K0553 — Supply allowance for therapeutic continuous glucose monitor (CGM), includes all supplies and accessories, 1 month supply = 1 unit of service
- K0554 — Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system
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 K0552
- Watch K0552 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for K0552
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.