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March 11, 2025

April 2025 HCPCS Updates – New, Revised, and Discontinued HCPCS Codes and Modifiers

The following information is based on the April 2025 Healthcare Common Procedure Coding System (HCPCS) file. There are several updates that will be effective April 1, 2025. Please keep in mind that the appearance of a HCPCS code is not an indication of coverage by the DME MAC.

This following list contains added HCPCS codes that will be effective April 1, 2025.

HCPCS DESCRIPTION
A6515 Gradient compression wrap with adjustable straps, full leg, each, custom
A6516 Gradient compression wrap with adjustable straps, foot, each, custom
A6517 Gradient compression wrap with adjustable straps, below knee, each, custom
A6518 Gradient compression wrap with adjustable straps, arm, each, custom
A6519 Gradient compression garment, not otherwise specified, for nighttime use, each
A6611 Gradient compression wrap with adjustable straps, above knee, each, custom
A9154 Artificial saliva, 1 ml
E0201 Penile contracture device, manual, greater than 3 lbs. traction force
E1022 Wheelchair transportation securement system, any type includes all components and accessories
E1023 Wheelchair transit securement system, includes all components and accessories
E1032 Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface
E1033 Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type
E1034 Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type
E1832 Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
J0281 Injection, aminocaproic acid, 1 gram
J1072 Injection, testosterone cypionate (azmiro), 1 mg
J1271 Injection, doxycycline hyclate, 1 mg
J1299 Injection, eculizumab, 2 mg
J1308 Injection, famotidine, 0.25 mg
J1808 Injection, folic acid, 0.1 mg
J1938 Injection, furosemide, 1 mg
J2351 Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq
J2428 Injection, paliperidone palmitate extended release (erzofri), 1 mg
J2804 Injection, rifampin, 1 mg
J2865 Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg
J7521 Tacrolimus, granules, oral suspension, 0.1 mg
J9024 Injection, atezolizumab, 5 mg and hyaluronidase-tqjs
J9038 Injection, axatilimab-csfr, 0.1 mg
J9054 Injection, bortezomib (boruzu), 0.1 mg
J9161 Injection, denileukin diftitox-cxdl, 1 mcg
L0720 Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L1933 Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf
L1952 Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf
L5827 Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping
L6028 Partial hand including fingers, flexible or non-flexible interface, endoskeletal system, molded to patient model, for use without external power, not including inserts described by L6692
L6029 Upper extremity addition, test socket/interface, partial hand including fingers
L6030 Upper extremity addition, external frame, partial hand including fingers
L6031 Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power
L6032 Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)
L6033 Addition to upper extremity prosthesis, partial hand including fingers, acrylic material
L6037 Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers
L6700 Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement
L7406 Addition to upper extremity, user adjustable, mechanical, residual limb volume management system
L1006 Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L1653 Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf
L1821 Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf
L8720 External lower extremity sensory prosthesis, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg
L8721 Receptor sole for use with L8720, replacement, each
Q5147 Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg
Q5148 Injection, filgrastim-txid (nypozi), biosimilar, 1 microgram
Q5149 Injection, aflibercept-abzv (enzeevu), biosimilar, 1 mg
Q5150 Injection, aflibercept-mrbb (ahzantive), biosimilar, 1 mg
Q5151 Injection, eculizumab-aagh (epysqli), biosimilar, 2 mg
Q5152 Injection, eculizumab-aeeb (bkemv), biosimilar, 2 mg

The following HCPCS codes have description/verbiage changes that will be effective April 1, 2025.

HCPCS DESCRIPTION
A4453 Rectal catheter with or without balloon, for use with any type transanal irrigation system, each
A4459 Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type
A6549 Gradient compression garment, not otherwise specified, for daytime use, each
A6583 Gradient compression wrap with adjustable straps, below knee, each
A6585 Gradient compression wrap with adjustable straps, above knee, each
A6586 Gradient compression wrap with adjustable straps, full leg, each
A6587 Gradient compression wrap with adjustable straps, foot, each
A6588 Gradient compression wrap with adjustable straps, arm, each
E1005 Wheelchair accessory, power seating system, recline only, with power shear reduction
E1028 Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other
E1801 Static progressive stretch/patient actualized serial stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
E1811 Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
E1816 Static progressive stretch/patient actualized serial stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories
E1818 Static progressive stretch/patient actualized serial stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories
E1841 Static progressive stretch/patient actualized serial stretch shoulder device, with or without range of motion adjustment, includes all components and accessories
J9073 Injection, cyclophosphamide (dr. reddy's), 5 mg
L1932 Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L1951 Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L1971 Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment
L6692 Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each
L6698 Addition to upper extremity prosthesis, lock mechanism, excludes socket insert

 The following listing contains discontinued HCPCS codes, along with the cross-walked HCPCS codes (if applicable). Please note, not all discontinued HCPCS codes will have a cross-walked HCPCS code.

HCPCS DISCONTINUE DATE CROSSWALK HCPCS CODE
J1094 03/31/2025  
J1300 03/31/2025  
J1810 03/31/2025  
J1890 03/31/2025  
J1940 03/31/2025  
J9037 03/31/2025  
J9247 03/31/2025  
L8010 03/31/2025  
Q5139 03/31/2025  

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