A4750 Hemodialysis Blood Tubing | HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS A4750: Blood Tubing for Hemodialysis

HCPCS Level II code A4750 represents blood tubing, arterial or venous, used during hemodialysis. This supply item is a routine component of extracorporeal dialysis circuits and is essential to the safe and effective delivery of hemodialysis nationwide. Because supplies like blood tubing are consumable items billed alongside dialysis sessions, they influence per-treatment supply costs and billing practice patterns across providers and payers.

Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national view of coding context and payer coverage approaches rather than state-specific rules.

Readers will find a concise explanation of what A4750 covers, the typical clinical setting for use, and what to expect in payer coverage and billing practice. The report summarizes benchmark considerations, common billing modifiers and claim handling (where available), and clinical context for supply use in hemodialysis workflows. Data gaps are noted when input information is unavailable. This brief is intended to support revenue cycle professionals, clinicians involved in dialysis services, and policy analysts seeking clarity on the role of HCPCS Level II code A4750 in billing and reimbursement.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA4750HCPCS Level IIhemodialysisdialysis suppliesblood tubingoutpatient dialysismedical supplies

Billing Code Overview

HCPCS Level II code A4750 describes blood tubing, arterial or venous, for hemodialysis, each. This supply is used as part of hemodialysis therapy, functioning as the tubing set that connects the patient’s vascular access to the dialysis machine for blood circulation during treatment.

Service type: Hemodialysis supply
Typical site of service: Dialysis centers, hospital outpatient dialysis units, and other settings where hemodialysis is delivered

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with end-stage renal disease (ESRD) on maintenance hemodialysis presents to an outpatient dialysis center for a scheduled dialysis session. The dialysis nurse prepares the hemodialysis machine and vascular access. Single-use blood tubing sets are selected for the session: one arterial and one venous blood tubing set labeled for hemodialysis. The tubing is attached to the patient’s arteriovenous fistula (or graft) and the dialysis circuit, primed with saline, and used for blood flow during the dialysis treatment. At the end of the session the tubing is disconnected and discarded. The service is recorded for inventory and billing using the HCPCS Level II code A4750 for each blood tubing set used during the hemodialysis treatment.

Service Type: Durable medical supply / dialysis consumable used during hemodialysis.
Typical Site of Service: Outpatient dialysis center, hospital outpatient dialysis unit, or patient home when home hemodialysis is performed.
Typical Patient Scenario: Patients with ESRD receiving intermittent hemodialysis via an arteriovenous fistula, arteriovenous graft, or central venous dialysis catheter. The tubing is routinely replaced each treatment and billed per tubing set.

Coding Specifications

Modifier	Description

HCPCS A6574: Gradient Compression Arm Sleeve and Glove, Custom

HCPCS-A5057-OSTOMY-POUCH-DRAINABLE-EXTENDED-WEAR-CONVEX-FILTER

HCPCS Level II A5057: Ostomy Pouch, Drainable, Extended-Wear, Convex, Filtered

HCPCS-A6553-BELOW-KNEE-CUSTOM-COMPRESSION-STOCKING-30-40MMHG

HCPCS A6553: Below-Knee Custom Gradient Compression Stocking, 30–40 mmHg

HCPCS-A6529-GRADIENT-COMPRESSION-NIGHTTIME-BRA-CUSTOM

HCPCS A6529: Gradient Compression Bra, Nighttime, Custom

HCPCS-A6449-LIGHT-COMPRESSION-BANDAGE-3-TO-5-INCH-PER-YARD

HCPCS A6449: Light Compression Bandage, 3–5 Inch, Per Yard

HCPCS-A6242-HYDROGEL-WOUND-DRESSING-16-SQ-IN-OR-LESS

HCPCS A6242: Hydrogel Wound Dressing, Sterile, ≤16 sq. in.

HCPCS-A4465-NON-ELASTIC-EXTREMITY-BINDER

HCPCS A4465: Non-Elastic Binder for Extremity

HCPCS-A6216-GAUZE-PAD-16-SQ-IN-NONSTERILE

HCPCS A6216: Gauze Pad, Non-Impregnated, Non-Sterile, ≤16 sq in

HCPCS-A6578-GRADIENT-COMPRESSION-ARM-SLEEVE

HCPCS A6578: Gradient Compression Arm Sleeve, Each

HCPCS-A4258-SPRING-POWERED-LANCET-DEVICE

HCPCS A4258: Spring-Powered Lancet Device, Single-Use

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Taxonomy Code	Specialty	Notes
`363A00000X`	Nephrology	Physicians specializing in kidney disease who manage hemodialysis patients; orders and oversight of dialysis treatments.
`174400000X`	Dialysis Facility	Facility taxonomy for outpatient dialysis centers that provide and bill dialysis supplies.
`335100000X`	Registered Nurse	RNs who administer dialysis treatments and handle tubing setup and disposal.
`354A00000X`	Physician Assistant	PAs involved in dialysis patient care and supply utilization decisions.
`363L00000X`	Vascular Medicine	Specialists involved when vascular access issues affect dialysis tubing selection or use.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N18.6`	End stage renal disease	Primary indication for maintenance hemodialysis; patients require blood tubing sets for each session.
`N18.5`	Chronic kidney disease, stage 5	Often progresses to ESRD and initiation of hemodialysis; tubing sets used during treatments.
`Z99.2`	Dependence on renal dialysis	Denotes ongoing dialysis dependence; supports billing for dialysis supplies like `A4750`.
`I77.3`	Arteriovenous fistula, acquired	Presence of vascular access type used during hemodialysis; tubing connects to fistula/graft.
`T82.7XXA`	Infection and inflammatory reaction due to other cardiac and vascular device, implant and graft, initial encounter	Vascular access complications may alter tubing use or require additional supplies during access management.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`90935`	Hemodialysis procedure with single evaluation by a physician or other qualified health care professional, for patients in the hospital or ESRD facility; for one or more dialysis treatments per day	Primary dialysis procedure performed using blood tubing sets billed separately as supplies (`A4750`).
`90937`	Hemodialysis procedure requiring repeated evaluations, for ESRD patients receiving more than one dialysis treatment per day	Applies when multiple daily treatments use additional tubing sets billed with `A4750`.
`90945`	Dialysis procedure other than hemodialysis, peritoneal dialysis training and management (short term) — not directly hemodialysis but included for dialysis program billing context	May be billed in dialysis program care where supplies differ; included for workflow context.
`36415`	Collection of venous blood by venipuncture	Pre- or post-dialysis laboratory sampling commonly performed in the same encounter where tubing is used.
`36561`	Insertion of tunneled centrally inserted central venous catheter, for dialysis or chemofiltration (e.g., for hemodialysis access)	Performed when a dialysis catheter is placed; subsequent hemodialysis sessions will use tubing sets billed with `A4750`.

`00`	No modifier	General default when no modifier applies to the service.
`22`	Increased procedural services	Rarely used for supplies; may be appended when unusually extensive additional work related to supply management is documented.
`23`	Unusual anesthesia	Not typically applicable for dialysis tubing; not recommended for routine use.
`52`	Reduced services	When a dialysis session is started but shortened and fewer supplies are used than typical.
`53`	Discontinued procedure	When a dialysis session is terminated prior to planned tubing use or the tubing is not used due to unexpected cancellation.
`54`	Surgical care only	Not applicable to this supply code; used for surgical global period reporting for procedures.
`55`	Postoperative management only	Not applicable to this supply code.
`56`	Preoperative management only	Not applicable to this supply code.
`62`	Two surgeons	Not applicable to supply billing for dialysis tubing.
`78`	Return to operating room for a related procedure during the postoperative period	Not applicable to this supply code.
`80`	Assistant surgeon	Not applicable to supply billing for dialysis tubing.
`82`	Assistant surgeon when qualified resident not available	Not applicable to supply billing for dialysis tubing.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Not applicable to supply code.

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