Summary & Overview
HCPCS A4564: Disposable Pessary, Device Supply
HCPCS Level II code A4564 designates a disposable pessary supplied for management of pelvic organ support. This device-level code captures single-use vaginal pessaries provided to patients as part of conservative, non-surgical management of pelvic organ prolapse or related pelvic floor conditions. Nationally, device supply codes like A4564 matter because they affect coverage determinations, supply reimbursement, and out-of-pocket costs for patients seeking noninvasive pelvic support options.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find coverage and reimbursement context for a disposable pessary supply code, comparative benchmarks where available, typical sites of service for billing, and the clinical role of pessaries as a conservative management option. The summary also highlights common billing considerations such as supply classification and how device codes are used on service lines.
This publication provides a concise reference for payers, billing staff, and clinicians about the purpose of HCPCS Level II code A4564, expected clinical uses, and the payer landscape relevant to device supply billing. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code A4564 describes a disposable pessary supplied for patient use. A pessary is a device inserted into the vagina to support pelvic organs; the descriptor "disposable, any type" indicates a single-use, non-reusable vaginal support device intended for short-term or single-episode use.
Service Type: Medical device supply for pelvic support
Typical Site of Service: Outpatient clinic or office setting, ambulatory surgical center, or home use
Clinical & Coding Specifications
Clinical Context
A 58-year-old woman with symptomatic pelvic organ prolapse presents to a urogynecology clinic complaining of vaginal pressure and urinary frequency. After a pelvic examination, the clinician determines that a pessary trial is appropriate to provide temporary non-surgical support. A disposable pessary (A4564) is selected for single-use fitting and immediate symptomatic relief. The clinical workflow includes: a focused history and pelvic exam, selection and fitting of the disposable pessary, patient education on pessary care and follow-up, documentation of the device brand and size, and scheduling a follow-up visit to assess fit and symptom improvement. Typical sites of service are outpatient clinic, urogynecology or gynecology office, and ambulatory surgical center when combined with other procedures. The typical patient is female, often peri- or post-menopausal, requiring non-surgical management of pelvic organ prolapse or associated pelvic floor dysfunction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to fit or adjust the pessary is substantially greater than typically required. |
23 |