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HCPCS A4649 · Level II · A code

A4649: Surgical supply; miscellaneous, 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); 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 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 A4649

Medicare payment
no PFS amount
PFS status P
Coverage code
C
carrier judgment, so the Medicare contractor decides coverage
Practitioner MUE
1
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 1

TL;DR

CMS describes HCPCS A4649, added in 1982, as "Surgical supply; miscellaneous". The physician fee schedule lists A4649 with status P (bundled or excluded: no separate physician fee schedule payment), so the PFS carries no national amount for it. MUE limits for A4649: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 8 (MAI 3, Clinical: Data). 1 active LCD and 1 billing and coding article list A4649 across 2 states: L33831 (Surgical Dressings), A52437. OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1A (medical/surgical supplies); pricing indicator 46; type of service 9 (other medical items or services). Nearby codes: A4641, A4630, A4615, A4604.

A4649 descriptor and code status

The October 2026 HCPCS Level II file describes A4649 as “Surgical supply; miscellaneous”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes. Although searches often call it the "A4649 CPT code", A4649 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of A4649
FieldValue
Short descriptorSurgical supplies
Added to HCPCS1982-01-01
Last actionN (no maintenance), effective 1998-01-01
Coverage codeC: carrier judgment, so the Medicare contractor decides coverage
Pricing indicator46: DMEPOS contractor-priced (not otherwise classified, individual determination or gap-filled)
BETOS categoryD1A: medical/surgical supplies
Type of service9: other medical items or services

Medicare payment for A4649

The physician fee schedule lists A4649 with status P (bundled or excluded: no separate physician fee schedule payment), so the PFS carries no national amount for it. 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 P: bundled or excluded: no separate physician fee schedule payment. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

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 A4649

MUE limits for A4649: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 8 (MAI 3, Clinical: Data). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for A4649 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services13 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital83 Date of Service Edit: ClinicalClinical: Data

The MUE lookup for A4649 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A4649 in v323r0.

A4649 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 A4649 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A4649

1 active Local Coverage Determination and 1 billing and coding article list A4649. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Billing and Coding Articles listing A4649
ArticleTitleContractor(s)Related LCD
A52437Billing and Coding: Sentinel Lymph Node Biopsy – Medical Policy ArticleCGS Administrators, LLC—

Denials to expect on A4649

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A4649

CARC 151 · N362

units of A4649 exceed the practitioner MUE of 1 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for A4649 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A4649 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS A4649

What does HCPCS code A4649 describe?

"Surgical supply; miscellaneous" (short descriptor "Surgical supplies"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 1982-01-01; last action N (no maintenance) effective 1998-01-01.

Is A4649 a CPT code?

No: CMS maintains A4649 in HCPCS Level II, while the AMA maintains CPT. People do search "A4649 CPT code", and it goes in the same procedure-code field.

What does Medicare pay for A4649?

The physician fee schedule lists A4649 with status P (bundled or excluded: no separate physician fee schedule payment), so the PFS carries no national amount for it.

How many units of A4649 can be billed per day?

MUE limits for A4649: practitioner 1 (MAI 3, Clinical: Data); hospital outpatient 8 (MAI 3, Clinical: Data). For the practitioner MUE (MAI 3), units above 1 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover A4649?

Coverage code C (carrier judgment, so the Medicare contractor decides coverage). 1 active LCD and 1 billing and coding article list A4649 across 2 states: L33831 (Surgical Dressings), A52437.

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.