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HCPCS A4618 · Level II · A code

A4618: Breathing circuits, 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). 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.

Key facts for A4618

Medicare payment
$10.78 to $12.68
DMEPOS non-rural state fees (NU)
Coverage code
D
special coverage instructions apply
DME supplier MUE
12
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
0 / 0

TL;DR

CMS describes HCPCS A4618, added in 1990, as "Breathing circuits". DMEPOS fees for A4618, a IN (inexpensive and other routinely purchased items) item, run NU (purchased, new) $10.78 in AL, AZ, FL and 11 more to $12.68 in AR, CA, CO and 23 more (floor $10.78, ceiling $12.68); RR (rental) $1.25 in AL, FL, GA and 20 more to $1.47 in AR, AZ, CA and 22 more (floor $1.25, ceiling $1.47); UE (purchased, used) $8.08 in AL, AZ, FL and 11 more to $9.51 in AR, CA, CO and 23 more (floor $8.08, ceiling $9.51) in the October 2026 file. Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 12 (MAI 3, Nature of Equipment). No current LCD or billing article lists A4618; its HCPCS coverage code is D (special coverage instructions apply). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1E (other DME); pricing indicator 32; type of service A (used DME), P (lump-sum purchase of DME, prosthetics or orthotics), R (rental of DME). Nearby codes: A4615, A4630, A4604, A4595.

A4618 descriptor and code status

The October 2026 HCPCS Level II file describes A4618 as “Breathing circuits”. 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 A4618
FieldValue
Short descriptorBreathing circuits
Added to HCPCS1990-01-01
Last actionN (no maintenance), effective 1993-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator32: DMEPOS inexpensive and routinely purchased DME (floors and ceilings)
BETOS categoryD1E: other DME
Type of serviceA: used DME; P: lump-sum purchase of DME, prosthetics or orthotics; R: rental of DME

Medicare payment for A4618

DMEPOS fees for A4618, a IN (inexpensive and other routinely purchased items) item, run NU (purchased, new) $10.78 in AL, AZ, FL and 11 more to $12.68 in AR, CA, CO and 23 more (floor $10.78, ceiling $12.68); RR (rental) $1.25 in AL, FL, GA and 20 more to $1.47 in AR, AZ, CA and 22 more (floor $1.25, ceiling $1.47); UE (purchased, used) $8.08 in AL, AZ, FL and 11 more to $9.51 in AR, CA, CO and 23 more (floor $8.08, ceiling $9.51) in the October 2026 file. 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 IN (inexpensive and other routinely purchased items). 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 A4618 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
NU (purchased, new)$10.78 / $12.68$10.78 (AL, AZ, FL…) to $12.68 (AR, CA, CO…)—AK $29.04, HI $31.06, PR $13.77, VI $12.68
RR (rental)$1.25 / $1.47$1.25 (AL, FL, GA…) to $1.47 (AR, AZ, CA…)—AK $2.86, HI $3.11, PR $1.69, VI $1.47
UE (purchased, used)$8.08 / $9.51$8.08 (AL, AZ, FL…) to $9.51 (AR, CA, CO…)—AK $21.80, HI $23.31, PR $10.36, VI $9.51

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 A4618

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 12 (MAI 3, Nature of Equipment). 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 A4618 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital13 Date of Service Edit: ClinicalClinical: Data
DME supplier123 Date of Service Edit: ClinicalNature of Equipment

The MUE lookup for A4618 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A4618 in v323r0.

A4618 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 A4618 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A4618

No current LCD or billing and coding article lists A4618. The HCPCS coverage code D means special coverage instructions apply, and any National Coverage Determination for the service still applies.

Denials to expect on A4618

CARC 50 · N115

the service is not reasonable and necessary for the diagnosis on the claim

CARC 151 · N362

units of A4618 exceed the DME supplier MUE of 12 per date of service

CARC 4

the NU, RR, UE payment modifier is missing or does not match the item

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 A4618 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for A4618 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 A4618

What does HCPCS code A4618 describe?

"Breathing circuits" (short descriptor "Breathing circuits"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 1990-01-01; last action N (no maintenance) effective 1993-01-01.

Is A4618 a CPT code?

No. A4618 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for A4618?

DMEPOS fees for A4618, a IN (inexpensive and other routinely purchased items) item, run NU (purchased, new) $10.78 in AL, AZ, FL and 11 more to $12.68 in AR, CA, CO and 23 more (floor $10.78, ceiling $12.68); RR (rental) $1.25 in AL, FL, GA and 20 more to $1.47 in AR, AZ, CA and 22 more (floor $1.25, ceiling $1.47); UE (purchased, used) $8.08 in AL, AZ, FL and 11 more to $9.51 in AR, CA, CO and 23 more (floor $8.08, ceiling $9.51) in the October 2026 file.

How many units of A4618 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 12 (MAI 3, Nature of Equipment). For the DME supplier MUE (MAI 3), units above 12 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover A4618?

No current LCD or billing article lists A4618; its HCPCS coverage code is D (special coverage instructions apply).

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.