HCPCS Level II · Transportation, medical and surgical supplies
A5057Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each
✓ Active
Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About A5057
A5057 is an HCPCS Level II code in the A series (transportation, medical and surgical supplies), describing ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each.
It was added to HCPCS effective 01/01/2012.
Its Medicare coverage code is "D", meaning special Medicare coverage instructions apply.
Details
- Short description
- 1 pc ost pou w built-in conv
- Date added
- 01/01/2012
- Action effective
- 01/01/2012
- BETOS
- D1F
Related A50xx codes
- A5051Ostomy pouch, closed; with barrier attached (1 piece), each
- A5052Ostomy pouch, closed; without barrier attached (1 piece), each
- A5053Ostomy pouch, closed; for use on faceplate, each
- A5054Ostomy pouch, closed; for use on barrier with flange (2 piece), each
- A5055Stoma cap
- A5056Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each
- A5061Ostomy pouch, drainable; with barrier attached, (1 piece), each
- A5062Ostomy pouch, drainable; without barrier attached (1 piece), each
- A5063Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each
- A5071Ostomy pouch, urinary; with barrier attached (1 piece), each
- A5072Ostomy pouch, urinary; without barrier attached (1 piece), each
- A5073Ostomy pouch, urinary; for use on barrier with flange (2 piece), each
Common questions about A5057
Is HCPCS A5057 still valid?
- Yes. A5057 is active in the CMS October 2026 HCPCS file.
Does Medicare cover A5057?
- Its coverage code is "D": special Medicare coverage instructions apply. Check the local coverage determination for your region.