A4725 – Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis

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

Active code Special coverage instructions apply

HCPCS codeA4725
Long description
Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis
Short description
Dialys sol fld vol > 4999cc
Pricing indicator
00 Not separately priced by Part B (bundled, not covered or Part A only)
Medicare coverage
D Special coverage instructions apply
BETOS category
P9B Dialysis services (Non-Medicare fee schedule)
Added
January 1, 2002
Last change
January 1, 2015 – No change

Frequently asked questions

What is HCPCS code A4725?

A4725 is a HCPCS Level II code for dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysis.

Does Medicare cover A4725?

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.