`A5112` Urinary leg bag

Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 2 units per day (clinical), rationale: Clinical: CMS Workgroup
DME supplier: max 3 units per day (clinical), rationale: Published Contractor Policy

Medicare pricing for A5112

DMEPOS fee schedule, July 2026 (DME26-C)

no modifier, ostomy, tracheostomy and urological (OS): non-rural $41.95 to $49.35 in the contiguous states; $43.69 to $61.74 in AK, HI, PR and VI; ceiling $49.35, floor $41.95

Physician Fee Schedule (CY 2026, RVU26D)

Status P: bundled or excluded, no separate PFS payment.

Payer policies and prior authorization for A5112

Payer coverage policies that name A5112

A5112 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Urological Supplies (0533)	covered if criteria are met	Jul 30, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in KY, LA, MA, OH, VA, WV.

AZ: $53.00 (dme), effective Oct 1, 2026
CO: $32.30 (chp_plus, non-facility), effective Jul 1, 2026
FL: $28.35 (dme), effective Jul 1, 2026
IL: $33.84 (dme), effective Jan 1, 2026
IN: $27.84 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2014
KS: $36.18 (default), effective Jul 1, 2026
KY: $33.02 (dme), effective Jan 1, 2026
LA: $21.14 (dme), effective Jul 1, 2012
MA: $34.72 (dme_rates), effective Mar 1, 2026
MD: $41.95 (dme), effective Apr 1, 2026
MS: $39.48 (comprehensive), effective Jul 1, 2026
ND: $0.00 (dme), effective Aug 1, 2026
NE: $39.56 (dme), effective Jul 1, 2026
NY: $29.94 (dme), effective Jul 1, 2026
OH: $31.16 (dme), effective Jul 1, 2002
OK: $46.13 (dme), effective Jan 1, 2026
TX: $30.86 (dmepos_tos_9_e_j_l_and_r, Home Health Dme, non-facility), effective Mar 1, 2012
VA: $44.42 (dme), effective Dec 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $37.08 (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.

A5112 Urinary leg bag