HCPCS Level IIsuppliesActive
A4721
Dialysat sol fld vol > 999cc
BETOS: P9B
Effective: 2015-01-01
Description
Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Medicare Fee Schedule
2026 Medicare Physician Fee Schedule national payment rates
Statutory Exclusion
This code has a statutory exclusion from Medicare coverage.
Coverage Policies