A5057 – Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA5057
- Long description
- Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
- Short description
- 1 pc ost pou w built-in conv
- Pricing indicator
37Ostomy, tracheostomy and urological supplies- Medicare coverage
DSpecial coverage instructions apply- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 2012
- Last change
- January 1, 2012 – No change
Frequently asked questions
What is HCPCS code A5057?
A5057 is a HCPCS Level II code for ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each.
Does Medicare cover A5057?
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
- 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
- A5053 – Ostomy pouch, closed; for use on faceplate, 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
- 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
- A5072 – Ostomy pouch, urinary; without barrier attached (1 piece), each
- A5073 – Ostomy pouch, urinary; for use on barrier with flange (2 piece), each
- A5081 – Stoma plug or seal, any type
- A5082 – Continent device; catheter for continent stoma
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.