A4721 HCPCS Level II code: Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
A4721 is the HCPCS code for “Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis” in CMS’s October 2026 release, in effect from Oct 1, 2026.
Official description
A4721Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Short description: Dialysat sol fld vol > 999cc
HCPCS · United States
Notes for A4721
As CMS prints them, with any note A4721 takes from the headings above it.
Note
- CMS processing note 0017: SEE INTERMEDIARY MANUAL SECTION 3170.5 FOR COVERAGE INSTRUCTIONS PERTAINING TO E1510-E1600, E1620, E1630-E1699, A4650-A4663, A4690, A4712, A4730-A4870, A4890-A4927.
Medicare details
The indicators CMS publishes with A4721 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Medicare pricing
- Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)
- Type of service
- ESRD supplies
- BETOS category
- Dialysis services (Non-Medicare fee schedule)
- Added
- Jan 1, 2002
Where A4721 sits
- 1A codesAmbulance, supplies and miscellaneous
- 2Active code A4721Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code A4721 mean?
A4721 is the HCPCS code for “Dialysate solution, any concentration of dextrose, fluid volume greater than 999 cc but less than or equal to 1999 cc, for peritoneal dialysis” in CMS’s HCPCS Level II October 2026 release.
Does Medicare cover A4721?
CMS lists A4721’s Medicare coverage as “Special coverage instructions apply” and its pricing as “Service not separately priced by Part B (e.g., services not covered, bundled, used by Part A only, etc.)”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside A4721
All A codesA4707Bicarbonate concentrate, powder, for hemodialysis, per packetA4708Acetate concentrate solution, for hemodialysis, per gallonA4709Acid concentrate, solution, for hemodialysis, per gallonA4714Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallonA4719"y set" tubing for peritoneal dialysisA4720Dialysate solution, any concentration of dextrose, fluid volume greater than 249 cc, but less than or equal to 999 cc, for peritoneal dialysisA4722Dialysate solution, any concentration of dextrose, fluid volume greater than 1999 cc but less than or equal to 2999 cc, for peritoneal dialysisA4723Dialysate solution, any concentration of dextrose, fluid volume greater than 2999 cc but less than or equal to 3999 cc, for peritoneal dialysisA4724Dialysate solution, any concentration of dextrose, fluid volume greater than 3999 cc but less than or equal to 4999 cc, for peritoneal dialysisA4725Dialysate solution, any concentration of dextrose, fluid volume greater than 4999 cc but less than or equal to 5999 cc, for peritoneal dialysisA4726Dialysate solution, any concentration of dextrose, fluid volume greater than 5999 cc, for peritoneal dialysisA4728Dialysate solution, non-dextrose containing, 500 ml