HCPCS Level II A4407: Ostomy Skin Barrier with Flange, Extended Wear

Commercial payers pay $9 on average nationally for this procedure.

HCPCS Level II code A4407 describes an ostomy skin barrier with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller; this supplies an ostomy appliance skin barrier used for ostomy management, typically supplied as durable medical equipment for stoma care and used in the home or outpatient wound/ostomy clinic setting.

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National Reimbursement Benchmarks

Commercial national averages for HCPCS A4407 center around BUCA’s mean of $8.60, with notable differences among major payers. Blue Cross Blue Shield shows the highest mean at $9.90 and the largest spread between its 25th and 75th percentiles (range $3.60), while Aetna exhibits a narrower interquartile spread (range $6.20) but lower central tendency (mean $5.40). UnitedHealth Group and Cigna sit near the middle of the spectrum with means of $7.70 and $9.00 respectively, and median values around $6.00–$6.30.

Examining dispersion, Blue Cross Blue Shield’s P75–P25 range of $3.60 is the widest among the payers with full percentile data, indicating greater variability in higher-tier commercial payments; UnitedHealth Group’s range is $3.00, and BUCA’s interquartile range is $4.60. Aetna’s smaller interquartile spread relative to its mean suggests more consistency at lower reimbursement levels, while Cigna’s percentiles imply concentrated values at and above $6.30.

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HCPCS Level II A4407: Ostomy Skin Barrier with Flange, Extended Wear

Commercial payers pay $9 on average nationally for this procedure.

Customize your policy alerts

Sign up for hcpcs A4407 policy alerts

Get alerted when payer policies referencing A4407 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult ostomy patient requiring an extended-wear skin barrier with built-in convexity to maintain a secure seal around a stoma and manage peristomal creases or a retracted stoma. For example, a 68-year-old patient with a colostomy and peristomal skin folds presents for routine supply replacement. The wound/ostomy nurse evaluates a shallow, retracted stoma with peristomal irritation and determines that a solid, flexible, or accordion flange skin barrier with built-in convexity (size 4 x 4 inches or smaller) is clinically appropriate to improve stoma protrusion and appliance adhesion.

The clinical workflow: the ostomy nurse documents stoma type, measurements, and skin condition; verifies payer coverage and medical necessity; selects A4407 product appropriate for convex support and extended wear; applies the barrier and ostomy pouching system, providing brief patient education on wear time and signs of leakage; updates the medical record with product lot numbers and delivery; and submits DME claim with supporting clinical notes and appropriate modifier(s) to indicate place of service, medical necessity, or other billing circumstances.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29125`	Application of short arm splint (forearm to hand); static	May be used in the same episode of care for a patient with concomitant forearm/wrist fracture requiring immobilization while ostomy supplies are issued
`29130`	Application of finger splint; static	Applicable when a patient has a finger injury that affects ability to manage ostomy supplies; provided during same visit as patient training
`29515`	Application of short leg splint (calf to foot)	Relevant for patients with lower extremity fractures (e.g., tibia) receiving immobilization in the same acute care encounter
`97760`	Orthotic management and training, upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes	Used for patient instruction and training in use of ostomy appliances and related assistive devices as part of functional rehabilitation

Related Modifiers

7 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑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…
53	Modifier 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…
62	Modifier 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…
78	CPT 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…
80	CPT® 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…
82	Modifier 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 Code	Specialty	Notes
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
225100000X	Physical Therapist	Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
225200000X	Physical Therapy Assistant	(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
1835P1400X	Pain Management Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skills, providing integrated, comprehensive, and accessible healthcare services t…
173000000X	Legal Medicine	The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical …
207NP0225X	Pediatric Dermatology Physician	A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emph…
2080P0216X	Pediatric Rheumatology Physician	A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
1223P0221X	Pediatric Dentistry	An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through ado…

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

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29125`	Application of short arm splint (forearm to hand); static	May be used in the same episode of care for a patient with concomitant forearm/wrist fracture requiring immobilization while ostomy supplies are issued
`29130`	Application of finger splint; static	Applicable when a patient has a finger injury that affects ability to manage ostomy supplies; provided during same visit as patient training
`29515`	Application of short leg splint (calf to foot)	Relevant for patients with lower extremity fractures (e.g., tibia) receiving immobilization in the same acute care encounter
`97760`	Orthotic management and training, upper extremity(s), lower extremity(s) and/or trunk, each 15 minutes	Used for patient instruction and training in use of ostomy appliances and related assistive devices as part of functional rehabilitation

Related Modifiers

7 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
52	Modifier ‑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…
53	Modifier 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…
62	Modifier 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…
78	CPT 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…
80	CPT® 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…
82	Modifier 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 Code	Specialty	Notes
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
225100000X	Physical Therapist	Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
225200000X	Physical Therapy Assistant	(1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accred…
1835P1400X	Pain Management Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skills, providing integrated, comprehensive, and accessible healthcare services t…
173000000X	Legal Medicine	The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical …
207NP0225X	Pediatric Dermatology Physician	A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emph…
2080P0216X	Pediatric Rheumatology Physician	A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle …
1223P0221X	Pediatric Dentistry	An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through ado…

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

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

HCPCS Level II A4407: Ostomy Skin Barrier with Flange, Extended Wear

Sign up for hcpcs A4407 policy alerts

National Reimbursement Benchmarks

HCPCS Level II A4407: Ostomy Skin Barrier with Flange, Extended Wear

Sign up for hcpcs A4407 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What is the clinical indication for using an ostomy skin barrier with built-in convexity and extended wear, as described by HCPCS code `A4407`?

Which related CPT codes may be used in the same episode of care as the application of an ostomy skin barrier with HCPCS code `A4407`?

What ICD-10 codes are clinically relevant for patients receiving an ostomy skin barrier with HCPCS code `A4407`?

In what settings can an ostomy skin barrier with HCPCS code `A4407` be used and billed?

What is the HCPCS code for an ostomy skin barrier with a solid, flexible, or accordion flange, extended wear, and built-in convexity, 4 x 4 inches or smaller?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What is the clinical indication for using an ostomy skin barrier with built-in convexity and extended wear, as described by HCPCS code `A4407`?

Which related CPT codes may be used in the same episode of care as the application of an ostomy skin barrier with HCPCS code `A4407`?

What ICD-10 codes are clinically relevant for patients receiving an ostomy skin barrier with HCPCS code `A4407`?

In what settings can an ostomy skin barrier with HCPCS code `A4407` be used and billed?

What is the HCPCS code for an ostomy skin barrier with a solid, flexible, or accordion flange, extended wear, and built-in convexity, 4 x 4 inches or smaller?

References