A4385 — Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
A4385 is a HCPCS Level II code for ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each. It belongs to the Transportation, Medical & Surgical Supplies, Administrative section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
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 A4385 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: CMS Workgroup
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: CMS Workgroup
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 A4385
- Long descriptor
- Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each
- Short descriptor
- Ost skn barrier sld ext wear
- Added
- January 1, 2000
- BETOS
- D1F
- Pricing indicator
- 37 — DMEPOS
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.
Ostomy, tracheostomy and urological supplies. Price subject to floors and ceilings.
Codes adjacent to A4385
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4385 is not quite right, the correct code is very often within a few positions of it.
- A4377Ostomy pouch, drainable, for use on faceplate, plastic, each
- A4378Ostomy pouch, drainable, for use on faceplate, rubber, each
- A4379Ostomy pouch, urinary, with faceplate attached, plastic, each
- A4380Ostomy pouch, urinary, with faceplate attached, rubber, each
- A4381Ostomy pouch, urinary, for use on faceplate, plastic, each
- A4382Ostomy pouch, urinary, for use on faceplate, heavy plastic, each
- A4383Ostomy pouch, urinary, for use on faceplate, rubber, each
- A4384Ostomy faceplate equivalent, silicone ring, each
- A4387Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each
- A4388Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each
- A4389Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each
- A4390Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each
- A4391Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each
- A4392Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each
- A4393Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each
- A4394Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce
Questions about A4385
What is HCPCS code A4385?
A4385 is a HCPCS Level II code for ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4385?
The CMS HCPCS file marks A4385 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is A4385 paid under the physician fee schedule?
A4385 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.