S4026 — Procurement of donor sperm from sperm bank
S4026 is a HCPCS Level II code for procurement of donor sperm from sperm bank. It belongs to the Temporary National Codes (Non-Medicare) section. Medicare does not pay it — see the coverage note below before you bill it.
Medicare coverage: Not payable by Medicare
Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
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 statusI
Not valid for Medicare purposes. Medicare uses another code.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
The CMS record for S4026
- Long descriptor
- Procurement of donor sperm from sperm bank
- Short descriptor
- Procure donor sperm
- Added
- January 1, 2002
- 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 S4026
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If S4026 is not quite right, the correct code is very often within a few positions of it.
- S4017Incomplete cycle, treatment cancelled prior to stimulation, case rate
- S4018Frozen embryo transfer procedure cancelled before transfer, case rate
- S4020In vitro fertilization procedure cancelled before aspiration, case rate
- S4021In vitro fertilization procedure cancelled after aspiration, case rate
- S4022Assisted oocyte fertilization, case rate
- S4023Donor egg cycle, incomplete, case rate
- S4024Air polymer-type a intrauterine foam, per study dose
- S4025Donor services for in vitro fertilization (sperm or embryo), case rate
- S4027Storage of previously frozen embryos
- S4028Microsurgical epididymal sperm aspiration (mesa)
- S4030Sperm procurement and cryopreservation services; initial visit
- S4031Sperm procurement and cryopreservation services; subsequent visit
- S4035Stimulated intrauterine insemination (iui), case rate
- S4037Cryopreserved embryo transfer, case rate
- S4040Monitoring and storage of cryopreserved embryos, per 30 days
- S4042Management of ovulation induction (interpretation of diagnostic tests and studies, non-face-to-face medical management of the patient), per cycle
Questions about S4026
What is HCPCS code S4026?
S4026 is a HCPCS Level II code for procurement of donor sperm from sperm bank. It sits in the Temporary National Codes (Non-Medicare) section.
Does Medicare cover S4026?
The CMS HCPCS file marks S4026 as "Not payable by Medicare". Medicare does not pay this code. It may still be valid for another payer, but a Medicare claim carrying it will not be reimbursed.
How is S4026 paid under the physician fee schedule?
S4026 carries PFS status code I. Not valid for Medicare purposes. Medicare uses another code.