HCPCS Level II › A codes A4461 Surgicl dress hold non-reuseSurgical dressing holder, non-reusable, each
Medicare coverage: Carrier judgment Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 2 units per day (clinical), rationale: Clinical: CMS Workgroup Outpatient hospital: max 2 units per day (clinical), rationale: Clinical: CMS Workgroup Medicare pricing for A4461 DMEPOS fee schedule, July 2026 (DME26-C) no modifier, surgical dressings (SD): non-rural $4.70 in the contiguous states; $4.70 to $5.61 in AK, HI, PR and VI; ceiling $4.70, floor $4.00 Physician Fee Schedule (CY 2026, RVU26D) Status X: statutory exclusion, not paid under the PFS.
Payer policies and prior authorization for A4461 Medicaid fee-for-service Prior authorization required or conditional in LA, MA, VA, WV.
AZ: $5.05 (dme), effective Oct 1, 2026 CO: $3.21 (chp_plus, non-facility), effective Jul 1, 2026 IN: $3.92 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026 KS: $3.76 (default), effective Jul 1, 2026 LA: $2.11 (dme), effective Jul 1, 2012 MA: $3.83 (dme_rates), effective Mar 1, 2026 MD: $4.00 (dme), effective Apr 1, 2026 MS: $3.76 (comprehensive), effective Jul 1, 2026 NE: $4.11 (dme), effective Jul 1, 2026 OK: $4.70 (dme), effective Jan 1, 2026 TX: $3.29 (dmepos_tos_9_e_j_l_and_r, Home Health Dme, non-facility), effective Jan 1, 2007 VA: $4.23 (dme), effective Dec 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $3.52 (medical_equipment_supplies), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026 From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.