A4377 – Ostomy pouch, drainable, for use on faceplate, plastic, each

HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental

Active code Special coverage instructions apply

HCPCS codeA4377
Long description
Ostomy pouch, drainable, for use on faceplate, plastic, each
Short description
Drainable plstic pch w/o fp
Pricing indicator
37 Ostomy, tracheostomy and urological supplies
Medicare coverage
D Special coverage instructions apply
BETOS category
D1F Prosthetic/Orthotic devices
Added
January 1, 2000
Last change
January 1, 2003 – No change

Frequently asked questions

What is HCPCS code A4377?

A4377 is a HCPCS Level II code for ostomy pouch, drainable, for use on faceplate, plastic, each.

Does Medicare cover A4377?

The HCPCS file lists coverage code D: Special coverage instructions apply. Coverage and payment also depend on local coverage determinations and the patient’s plan.

Nearby A codes

Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.