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HCPCS A4616 · Level II · A code

A4616: Tubing (oxygen), per foot, HCPCS Level II A code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for A4616

Medicare payment
$0.08
DMEPOS non-rural state fees
Coverage code
D
special coverage instructions apply
DME supplier MUE
0
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

A4616 is a Level II code from the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), in use since 1990: "Tubing (oxygen), per foot". A4616 is paid from the DMEPOS fee schedule as supplies (SU): $0.08 in every contiguous state (floor $0.07, ceiling $0.08), October 2026. MUE limits for A4616: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 0 (MAI 3, Published Contractor Policy). 1 active LCD lists A4616: L33797 (Oxygen and Oxygen Equipment). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1C (oxygen and supplies); pricing indicator 00; type of service P (lump-sum purchase of DME, prosthetics or orthotics). 1 other active code opens with "Tubing"; related codes: A7002, A4615, A4604, A4630.

A4616 descriptor and code status

The October 2026 HCPCS Level II file describes A4616 as “Tubing (oxygen), per foot”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes.

HCPCS file attributes of A4616
FieldValue
Short descriptorTubing (oxygen) per foot
Added to HCPCS1990-01-01
Last actionN (no maintenance), effective 2009-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator00: not separately priced by Part B
BETOS categoryD1C: oxygen and supplies
Type of serviceP: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for A4616

A4616 is paid from the DMEPOS fee schedule as supplies (SU): $0.08 in every contiguous state (floor $0.07, ceiling $0.08), October 2026. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

DMEPOS fee schedule (DME26-D)

Jurisdiction D (DME MAC), payment category SU (supplies). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for A4616 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
none$0.07 / $0.08$0.08 (49 states)—AK $0.08, HI $0.08, PR $0.10, VI $0.08

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Medically Unlikely Edits for A4616

MUE limits for A4616: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 0 (MAI 3, Published Contractor Policy). The DME supplier MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for A4616 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital13 Date of Service Edit: ClinicalClinical: Data
DME supplier03 Date of Service Edit: ClinicalPublished Contractor Policy

The MUE lookup for A4616 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A4616 in v323r0.

A4616 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check A4616 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A4616

1 active Local Coverage Determination and 0 billing and coding articles list A4616. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on A4616

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A4616

CARC 151 · N362

units of A4616 exceed the DME supplier MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

For teams evaluating QuickIntell software

Where QuickIntell fits for A4616 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for A4616 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-up
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Optional software evaluation, not payer support or help with an individual claim. For coverage or payment decisions, use the official sources on this page. Do not include patient information in a demo booking or inquiry.

Frequently asked questions: HCPCS A4616

What does HCPCS code A4616 describe?

"Tubing (oxygen), per foot" (short descriptor "Tubing (oxygen) per foot"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 1990-01-01; last action N (no maintenance) effective 2009-01-01.

Is A4616 a CPT code?

No: CMS maintains A4616 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.

What does Medicare pay for A4616?

A4616 is paid from the DMEPOS fee schedule as supplies (SU): $0.08 in every contiguous state (floor $0.07, ceiling $0.08), October 2026.

How many units of A4616 can be billed per day?

MUE limits for A4616: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 0 (MAI 3, Published Contractor Policy). For the DME supplier MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover A4616?

Coverage code D (special coverage instructions apply). 1 active LCD lists A4616: L33797 (Oxygen and Oxygen Equipment).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.