2024 HCPCS Code A4728

Dialysate solution, non-dextrose containing, 500 ml

Short Description	Dialysate solution, non-dex
HCPCS Coverage Code	C - Carrier judgment
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	January 01, 2015
HCPCS Code Added Date	January 01, 2004
HCPCS Pricing Indicator Code	00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Multiple Pricing Indicator Code	9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code	L - ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)
HCPCS Anesthesia Base Unit Quantity	0