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    v1.0.28
    OpenPayerBilling CodesMedical And Surgical SuppliesHCPCS hcpcs-a4364-adhesive-liquid-supply-per-ounce
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    HCPCS A4364: Adhesive, Liquid, Per Ounce

    HCPCS Level II code A4364 describes a liquid adhesive product billed per ounce, intended for use as a general-purpose medical adhesive for wound closure, dressing fixation, or minor device attachment; service type: supply of adhesive product; typical site of service: outpatient clinics, physician offices, emergency departments, and ambulatory care settings where topical adhesive application or dressing securement is performed.

    For related coverage guidance, see recent payer policy updates: Salivary Hormone Testing, Bone Turnover Markers Testing, Parathyroid Hormone, Phosphorus, Calcium, and Magnesium Testing.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 45-year-old outpatient who presents to a wound care clinic after sustaining a small laceration to the forearm while gardening. The wound is cleaned, debris is irrigated, and superficial edges are approximated. The clinician elects to apply a topical tissue adhesive to close the epidermal layer instead of or in addition to sutures. The adhesive used is a liquid skin adhesive billed with A4364 (adhesive, liquid or equal, any type, per oz). The workflow includes wound assessment, cleansing, local anesthesia if needed, approximation of wound edges, application of the liquid adhesive in a thin layer over the approximated edges, drying time, and patient aftercare instructions. Typical sites of service include ambulatory surgical centers, emergency departments, urgent care clinics, physician offices, and wound care clinics. Common payer interactions include primary carrier verification and documentation of product quantity (ounces) applied, medical necessity tied to the wound closure, and any applicable modifiers to indicate unusual circumstances or billing circumstances.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    12001Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (2.5 cm or less)Commonly performed when closure requires simple layered repair; adhesive A4364 may be used instead of or in addition to sutures for epidermal approximation.
    12011Simple repair of superficial wounds of face, ears, eyelids, nose, lips (2.5 cm or less)Facial lacerations often are closed with tissue adhesive for cosmesis; adhesive supply billed with A4364 supports this closure.
    15100Surgical preparation and application of topical tissue adhesive (first 10 sq cm or less) — Note: This represents application technique codes relevant to skin adhesive useUsed in clinics that bill a procedure for application of tissue adhesive alongside supply billing of A4364 when an application code is appropriate.
    13160Secondary closure of wound, scalp, axillae, trunk, and/or extremities; complicated (includes undermining)In more complex closures requiring undermining or extensive preparation, adhesives may be used adjunctively; A4364 covers the adhesive supply.
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedureOften used to report discrete supplies like tissue adhesives when payers require a supply-specific charge or when A4364 is not accepted; relates to A4364 as alternate supply reporting.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207Q00000XFamily Medicine PhysicianFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadt…
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    364S00000XClinical Nurse SpecialistA registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses…
    332BC3200XCustomized Equipment (DME)Suppliers · Durable Medical Equipment & Medical Supplies
    163WF0300XFlight Registered NurseNursing Service Providers · Registered Nurse
    251T00000XPACE Provider OrganizationA PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated manage…

    Related ICD-10-CM Codes

    26 rows

    ICD-10-CM CodeDescription
    B35.1Tinea unguium
    B37.2Candidiasis of skin and nail
    L03.031Cellulitis of right toe
    L03.116Cellulitis of left lower limb
    L03.311Cellulitis of abdominal wall
    L60.0Ingrowing nail
    L89.101Pressure ulcer of unspecified part of back, stage 1
    L89.201Pressure ulcer of unspecified hip, stage 1
    L89.301Pressure ulcer of unspecified buttock, stage 1
    L97.411Non-pressure chronic ulcer of right heel and midfoot limited to breakdown of skin

    Showing 1–10 of 26

    Related Payer Policy Updates

    Specialty: Endocrinology1 / 3

    5 rows

    PolicyPayerEffective Date
    Salivary Hormone TestingOscar Health2026-10-01
    Bone Turnover Markers TestingOscar Health2026-10-01
    Parathyroid Hormone, Phosphorus, Calcium, and Magnesium TestingOscar Health2026-10-01
    Testosterone — Coverage Criteria for Measurement and MonitoringOscar Health2026-10-01
    Thyroid Disease TestingOscar Health2026-10-01

    Related Codes

    HCPCS-A4206-STERILE-SYRINGE-1CC-NEEDLE

    HCPCS A4206: Syringe with Needle, 1 cc or Less, Sterile

    HCPCS-A4207-STERILE-2CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4207: Syringe with Needle, Sterile 2 cc

    HCPCS-A4208-STERILE-3CC-SYRINGE-WITH-NEEDLE

    HCPCS Level II A4208: Syringe with Needle, Sterile 3 cc

    HCPCS-A4209-STERILE-SYRINGE-WITH-NEEDLE-5CC-OR-GREATER

    HCPCS Level II A4209: Syringe with Needle, Sterile 5 cc or Greater

    HCPCS-A4210-NEEDLE-FREE-INJECTION-DEVICE

    HCPCS Level II A4210: Needle-free Injection Device, Each

    HCPCS-A4211-SUPPLIES-SELF-ADMINISTERED-INJECTIONS

    HCPCS Level II A4211: Supplies for Self-Administered Injections

    HCPCS-A4212-NON-CORING-NEEDLE-STYLET-CATHETER-ACCESS-SUPPLY

    HCPCS Level II A4212: Non-coring Needle or Stylet with/without Catheter

    HCPCS-A4213-STERILE-SYRINGE-20CC-OR-GREATER

    HCPCS Level II A4213: Syringe, Sterile, 20 cc or Greater, Each

    HCPCS-A4215-STERILE-NEEDLE-SINGLE-EACH

    HCPCS Level II A4215: Needle, Sterile, Any Size

    HCPCS-A4216-STERILE-DILUENT-FLUSH-10ML

    HCPCS Level II A4216: Sterile Diluent/Flush, 10 ml

    Showing 1–10 of 633

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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