A4640 — Replacement pad for use with medically necessary alternating pressure pad owned by patient
A4640 is a HCPCS Level II code for replacement pad for use with medically necessary alternating pressure pad owned by patient. 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 A4640 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- DME supplier
- 1 unit MAI 2 — Date of Service Edit: Policy · Code Descriptor / CPT Instruction
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 A4640
- Long descriptor
- Replacement pad for use with medically necessary alternating pressure pad owned by patient
- Short descriptor
- Alternating pressure pad
- Added
- January 1, 1991
- 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 A4640
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If A4640 is not quite right, the correct code is very often within a few positions of it.
- 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
- A4639Replacement pad for infrared heating pad system, each
- A4641Radiopharmaceutical, diagnostic, not otherwise classified
- A4642Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
- A4648Tissue marker, implantable, any type, each
- A4649Surgical supply; miscellaneous
- A4650Implantable radiation dosimeter, each
- A4651Calibrated microcapillary tube, each
- A4652Microcapillary tube sealant
- A4653Peritoneal dialysis catheter anchoring device, belt, each
Questions about A4640
What is HCPCS code A4640?
A4640 is a HCPCS Level II code for replacement pad for use with medically necessary alternating pressure pad owned by patient. It sits in the Transportation, Medical & Surgical Supplies, Administrative section.
Does Medicare cover A4640?
The CMS HCPCS file marks A4640 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 A4640 paid under the physician fee schedule?
A4640 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.