Skip to main content
Call AIBook a demo
HCPCS A7045 · Level II · A code

A7045: Exhalation port with or without swivel used with accessories for positive airway devices, 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 A7045

Medicare payment
$14.11 to $16.69
DMEPOS non-rural state fees (NU)
Coverage code
D
special coverage instructions apply
DME supplier MUE
2
MAI 3
OPPS status
SI Y
Non-implantable DME
NCCI PTP pairs
0
practitioner file
LCDs and articles
2 / 0

TL;DR

CMS describes HCPCS A7045, added in 2005, as "Exhalation port with or without swivel used with accessories for positive airway devices, replacement only". DMEPOS fees for A7045, a IN (inexpensive and other routinely purchased items) item, run NU (purchased, new) $14.11 in CO, ID, MT and 2 more to $16.69 in CT, MA, ME and 3 more, rural $20.35; RR (rental) $1.41 in CO, ID, MT and 2 more to $1.67 in CT, MA, ME and 3 more, rural $2.03; UE (purchased, used) $10.58 in CO, ID, MT and 2 more to $12.52 in CT, MA, ME and 3 more, rural $15.27 in the October 2026 file. Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 2 (MAI 3, Clinical: Data). 2 active LCDs list A7045: L33718 (Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea), L33800 (Respiratory Assist Devices). OPPS status indicator Y: Non-implantable DME. 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: A7046, A7048, A7039, A7038.

A7045 descriptor and code status

The October 2026 HCPCS Level II file describes A7045 as “Exhalation port with or without swivel used with accessories for positive airway devices, replacement only”. 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 A7045
FieldValue
Short descriptorRepl exhalation port for pap
Added to HCPCS2005-01-01
Last actionN (no maintenance), effective 2005-01-01
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 A7045

DMEPOS fees for A7045, a IN (inexpensive and other routinely purchased items) item, run NU (purchased, new) $14.11 in CO, ID, MT and 2 more to $16.69 in CT, MA, ME and 3 more, rural $20.35; RR (rental) $1.41 in CO, ID, MT and 2 more to $1.67 in CT, MA, ME and 3 more, rural $2.03; UE (purchased, used) $10.58 in CO, ID, MT and 2 more to $12.52 in CT, MA, ME and 3 more, rural $15.27 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 A7045 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
NU (purchased, new)—$14.11 (CO, ID, MT…) to $16.69 (CT, MA, ME…)$20.35 (49 states)AK $20.30, HI $20.30, PR $22.69, VI $20.30
RR (rental)—$1.41 (CO, ID, MT…) to $1.67 (CT, MA, ME…)$2.03 (49 states)AK $2.03, HI $2.03, PR $2.27, VI $2.03
UE (purchased, used)—$10.58 (CO, ID, MT…) to $12.52 (CT, MA, ME…)$15.27 (49 states)AK $15.23, HI $15.23, PR $17.03, VI $15.23

Hospital outpatient (OPPS Addendum B)

Status indicator Y (Non-implantable DME), with no separate OPPS payment rate.

Medically Unlikely Edits for A7045

Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 2 (MAI 3, Clinical: Data). 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 A7045 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier23 Date of Service Edit: ClinicalClinical: Data

The MUE lookup for A7045 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A7045 in v323r0.

A7045 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 A7045 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A7045

2 active Local Coverage Determinations and 0 billing and coding articles list A7045. 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 A7045

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A7045

CARC 151 · N362

units of A7045 exceed the DME supplier MUE of 2 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 A7045 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for A7045 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
Book a software demoAsk about a software workflow

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 A7045

What does HCPCS code A7045 describe?

"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only" (short descriptor "Repl exhalation port for pap"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2005-01-01.

Is A7045 a CPT code?

No. A7045 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.

What does Medicare pay for A7045?

DMEPOS fees for A7045, a IN (inexpensive and other routinely purchased items) item, run NU (purchased, new) $14.11 in CO, ID, MT and 2 more to $16.69 in CT, MA, ME and 3 more, rural $20.35; RR (rental) $1.41 in CO, ID, MT and 2 more to $1.67 in CT, MA, ME and 3 more, rural $2.03; UE (purchased, used) $10.58 in CO, ID, MT and 2 more to $12.52 in CT, MA, ME and 3 more, rural $15.27 in the October 2026 file.

How many units of A7045 can be billed per day?

Its 2026 Q4 MUEs per date of service: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 0 (MAI 3, CMS Policy); DME supplier 2 (MAI 3, Clinical: Data). For the DME supplier MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover A7045?

Coverage code D (special coverage instructions apply). 2 active LCDs list A7045: L33718 (Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea), L33800 (Respiratory Assist Devices).

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.