A4290 — Sacral nerve stimulation test lead, each
A4290 is a HCPCS Level II code for sacral nerve stimulation test lead, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of A4290 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for A4290
- Long descriptor
- Sacral nerve stimulation test lead, each
- Short descriptor
- Sacral nerve stim test lead
- Added
- January 1, 2001
- BETOS
- Z2
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to A4290
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4290 is not quite right, the correct code is very often within a few positions of it.
- A4281Tubing for breast pump, replacement
- A4282Adapter for breast pump, replacement
- A4283Cap for breast pump bottle, replacement
- A4284Breast shield and splash protector for use with breast pump, replacement
- A4285Polycarbonate bottle for use with breast pump, replacement
- A4286Locking ring for breast pump, replacement
- A4287Disposable collection and storage bag for breast milk, any size, any type, each
- A4288Valve for breast pump, replacement
- A4295Intermittent urinary catheter; straight tip, hydrophilic coating, each
- A4296Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each
- A4297Intermittent urinary catheter; hydrophilic coating, with insertion supplies
- A4300Implantable access catheter, (e.g., venous, arterial, epidural subarachnoid, or peritoneal, etc.) external access
- A4301Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)
- A4305Disposable drug delivery system, flow rate of 50 ml or greater per hour
- A4306Disposable drug delivery system, flow rate of less than 50 ml per hour
- A4310Insertion tray without drainage bag and without catheter (accessories only)
Questions about A4290
What is HCPCS code A4290?
A4290 is a HCPCS Level II code for sacral nerve stimulation test lead, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4290?
The CMS HCPCS file marks A4290 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is A4290 paid under the physician fee schedule?
A4290 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.