A4765 – Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA4765
- Long description
- Dialysate concentrate, powder, additive for peritoneal dialysis, per packet
- Short description
- Dialysate conc pow per pack
- 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, 1986
- Last change
- January 1, 2015 – No change
Frequently asked questions
What is HCPCS code A4765?
A4765 is a HCPCS Level II code for dialysate concentrate, powder, additive for peritoneal dialysis, per packet.
Does Medicare cover A4765?
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
- A4728 – Dialysate solution, non-dextrose containing, 500 ml
- A4730 – Fistula cannulation set for hemodialysis, each
- A4736 – Topical anesthetic, for dialysis, per gram
- A4737 – Injectable anesthetic, for dialysis, per 10 ml
- A4740 – Shunt accessory, for hemodialysis, any type, each
- A4750 – Blood tubing, arterial or venous, for hemodialysis, each
- A4755 – Blood tubing, arterial and venous combined, for hemodialysis, each
- A4760 – Dialysate solution test kit, for peritoneal dialysis, any type, each
- A4766 – Dialysate concentrate, solution, additive for peritoneal dialysis, per 10 ml
- A4770 – Blood collection tube, vacuum, for dialysis, per 50
- A4771 – Serum clotting time tube, for dialysis, per 50
- A4772 – Blood glucose test strips, for dialysis, per 50
- A4773 – Occult blood test strips, for dialysis, per 50
- A4774 – Ammonia test strips, for dialysis, per 50
- A4802 – Protamine sulfate, for hemodialysis, per 50 mg
- A4860 – Disposable catheter tips for peritoneal dialysis, per 10
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.