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    v1.0.28
    OpenPayerBilling CodesDurable medical equipment (DME) Medicare administrative contractors (MACs)HCPCS hcpcs-k0552-syringe-cartridge-external-drug-infusion-pump
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    HCPCS Level II K0552: Syringe-Type Cartridge for External Drug Infusion Pump

    HCPCS Level II code K0552 describes a sterile syringe-type cartridge supply designed for use with external non-insulin drug infusion pumps; the service is classified as a durable medical equipment supply for infusion therapy and the typical site of service is outpatient infusion settings or other ambulatory care locations where external drug infusion pumps are used.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with a chronic condition requiring continuous subcutaneous or intermittent bolus administration of a non‑insulin medication (for example, pain management with opioid or non-opioid infusions, chemotherapy supportive agents, or other specialty biologic agents) delivered via an external syringe‑type cartridge infusion pump. The device is a non‑insulin, syringe‑type cartridge pump supplied sterile and replaced per manufacturer guidance. Clinical workflow: a prescriber documents medical necessity and orders the external non‑insulin drug infusion pump supplies (K0552). The supplier prepares the sterile syringe‑type cartridge and provides patient education on pump operation, infusion rates, and safe handling. Nursing or durable medical equipment (DME) staff may assist with initial setup in an outpatient clinic, ambulatory infusion center, or the patient’s home. Follow‑up visits assess infusion site, device function, therapy tolerance, and supply replenishment. Typical sites of service include outpatient infusion centers, ambulatory surgical centers for procedures requiring short-term non‑insulin infusion, and patient homes when DME services are delivered.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96365Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hourMay be used for billing infusion administration when a clinician administers or supervises a non‑insulin drug infusion session associated with the supplied pump
    96366Intravenous infusion, each additional hour (list separately in addition to code for primary service)Used for extended infusion time beyond the initial hour when clinician services are furnished
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesUsed for clinician follow‑up visits assessing pump therapy, troubleshooting, and refill orders
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedureMay be used when billing additional non‑DME supplies associated with infusion that are not separately reimbursed
    G0511Services furnished by qualified personnel in the home under home health supervision (CMS G‑code)Used when supervising home infusion therapy and DME supply provision by home health staff

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    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
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    367H00000XAnesthesiologist AssistantAn individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants …
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    332U00000XHome Delivered MealsHome-delivered meals are those services or activities designed to prepare and deliver one or more meals a day to an individual's residence in order to…
    261QC1500XCommunity Health Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    2084S0010XSports Medicine (Psychiatry & Neurology) PhysicianA psychiatrist or neurologist who specializes in the diagnosis and treatment of sports related conditions and injuries.
    101YM0800XMental Health CounselorBehavioral Health & Social Service Providers · Counselor
    3336I0012XInstitutional PharmacyA pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered …

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    5 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01
    General Durable Medical Equipment (DME) Medical GuidelineWPS Health Insurance2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    Related Codes

    HCPCS-K0001-STANDARD-WHEELCHAIR-DURABLE-MEDICAL-EQUIPMENT

    HCPCS K0001: Standard Wheelchair

    HCPCS-K0002-STANDARD-HEMI-LOW-SEAT-WHEELCHAIR

    HCPCS K0002: Standard Hemi (Low Seat) Wheelchair

    HCPCS-K0003-LIGHTWEIGHT-WHEELCHAIR

    HCPCS K0003: Lightweight Wheelchair

    HCPCS-K0004-HIGH-STRENGTH-LIGHTWEIGHT-WHEELCHAIR

    HCPCS K0004: High Strength, Lightweight Wheelchair

    HCPCS-K0005-ULTRALIGHTWEIGHT-WHEELCHAIR

    HCPCS Level II K0005: Ultralightweight Wheelchair

    HCPCS-K0006-HEAVY-DUTY-WHEELCHAIR

    HCPCS Level II K0006: Heavy Duty Wheelchair

    HCPCS-K0007-EXTRA-HEAVY-DUTY-WHEELCHAIR

    HCPCS Level II K0007: Extra Heavy Duty Wheelchair

    HCPCS-K0008-CUSTOM-MANUAL-WHEELCHAIR

    HCPCS K0008: Custom Manual Wheelchair/Base

    HCPCS-K0009-OTHER-MANUAL-WHEELCHAIR-BASE

    HCPCS K0009: Other Manual Wheelchair/Base

    HCPCS-K0010-STANDARD-WEIGHT-FRAME-POWER-WHEELCHAIR

    HCPCS K0010: Standard Weight Frame Motorized/Power Wheelchair

    Showing 1–10 of 135

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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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