A5053 – Ostomy pouch, closed; for use on faceplate, each
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA5053
- Long description
- Ostomy pouch, closed; for use on faceplate, each
- Short description
- Clsd ostomy pouch faceplate
- Pricing indicator
37Ostomy, tracheostomy and urological supplies- Medicare coverage
DSpecial coverage instructions apply- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 1990
- Last change
- January 1, 2003 – No change
Frequently asked questions
What is HCPCS code A5053?
A5053 is a HCPCS Level II code for ostomy pouch, closed; for use on faceplate, each.
Does Medicare cover A5053?
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
- A4927 – Gloves, non-sterile, per 100
- A4928 – Surgical mask, per 20
- A4929 – Tourniquet for dialysis, each
- A4930 – Gloves, sterile, per pair
- A4931 – Oral thermometer, reusable, any type, each
- A4932 – Rectal thermometer, reusable, any type, each
- A5051 – Ostomy pouch, closed; with barrier attached (1 piece), each
- A5052 – Ostomy pouch, closed; without barrier attached (1 piece), each
- A5054 – Ostomy pouch, closed; for use on barrier with flange (2 piece), each
- A5055 – Stoma cap
- A5056 – Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
- A5057 – Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
- A5061 – Ostomy pouch, drainable; with barrier attached, (1 piece), each
- A5062 – Ostomy pouch, drainable; without barrier attached (1 piece), each
- A5063 – Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
- A5071 – Ostomy pouch, urinary; with barrier attached (1 piece), each
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.