A4628 — Oral and/or oropharyngeal suction catheter, each
A4628 is a HCPCS Level II code for oral and/or oropharyngeal suction catheter, 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 A4628 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 36 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
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 A4628
- Long descriptor
- Oral and/or oropharyngeal suction catheter, each
- Short descriptor
- Oropharyngeal suction cath
- Added
- January 1, 1996
- BETOS
- D1E
- Pricing indicator
- 32 — 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.
Inexpensive and routinely purchased DME. Price subject to floors and ceilings.
Codes adjacent to A4628
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4628 is not quite right, the correct code is very often within a few positions of it.
- A4618Breathing circuits
- A4619Face tent
- A4620Variable concentration mask
- A4623Tracheostomy, inner cannula
- A4624Tracheal suction catheter, any type other than closed system, each
- A4625Tracheostomy care kit for new tracheostomy
- A4626Tracheostomy cleaning brush, each
- A4627Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler
- A4629Tracheostomy care kit for established tracheostomy
- A4630Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient
- A4633Replacement bulb/lamp for ultraviolet light therapy system, each
- A4634Replacement bulb for therapeutic light box, tabletop model
- A4635Underarm pad, crutch, replacement, each
- A4636Replacement, handgrip, cane, crutch, or walker, each
- A4637Replacement, tip, cane, crutch, walker, each.
- A4638Replacement battery for patient-owned ear pulse generator, each
Questions about A4628
What is HCPCS code A4628?
A4628 is a HCPCS Level II code for oral and/or oropharyngeal suction catheter, each. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4628?
The CMS HCPCS file marks A4628 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 A4628 paid under the physician fee schedule?
A4628 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.