A4720 – Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA4720
- Long description
- Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis
- Short description
- Dialysat sol fld vol > 249cc
- Pricing indicator
00Not separately priced by Part B (bundled, not covered or Part A only)- Medicare coverage
DSpecial coverage instructions apply- BETOS category
P9BDialysis services (Non-Medicare fee schedule)- Added
- January 1, 2002
- Last change
- January 1, 2015 – No change
Frequently asked questions
What is HCPCS code A4720?
A4720 is a HCPCS Level II code for dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysis.
Does Medicare cover A4720?
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
- A4680 – Activated carbon filter for hemodialysis, each
- A4690 – Dialyzer (artificial kidneys), all types, all sizes, for hemodialysis, each
- A4706 – Bicarbonate concentrate, solution, for hemodialysis, per gallon
- A4707 – Bicarbonate concentrate, powder, for hemodialysis, per packet
- A4708 – Acetate concentrate solution, for hemodialysis, per gallon
- A4709 – Acid concentrate, solution, for hemodialysis, per gallon
- A4714 – Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon
- A4719 – "y set" tubing for peritoneal dialysis
- A4721 – Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
- A4722 – Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysis
- A4723 – Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysis
- A4724 – Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysis
- A4725 – Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
- A4726 – Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysis
- A4728 – Dialysate solution, non-dextrose containing, 500 ml
- A4730 – Fistula cannulation set for hemodialysis, each
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.