Written and maintained by CASRAI Editorial Board
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This page describes products and general use; it is not medical advice.
A4351 is the HCPCS Level II code for an intermittent urinary catheter with a straight tip, with or without coating, counted per catheter (“each”). This page is for clinic staff, supply buyers and students who need to tell A4351 apart from the neighbouring catheter and drainage-bag codes (A4352, A4353, A4354, A4357, A4358). It covers what each code describes and how the products are classified by the FDA. It does not cover coverage, reimbursement or price.
What A4351 describes
The CMS HCPCS Level II file gives A4351 the long descriptor: “Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each” (short descriptor: “Straight tip urine catheter”). The code has been effective in its current wording since 2026-01-01 per the CMS data as published through the NLM Clinical Tables HCPCS service (checked 2026-10-30).
Three things follow directly from the descriptor. The catheter is intermittent, meaning a product used and removed rather than a retention (indwelling) catheter such as a Foley catheter. The tip is straight, not curved. And the unit is each: one code unit is one catheter, not a box. A HCPCS code names a category of product; it does not name a brand, a size (French gauge) or a length, and the descriptor says nothing about those.
Who uses it: the code appears in supply catalogues, clinic inventory lists and billing-software code tables, so it is handled by clinic supply staff, medical coders and buyers. Straight intermittent catheters of the kind it describes are also covered on CASRAI in the Robinson catheter guide.
A4351 vs A4352: straight tip vs coude tip
The two descriptors are identical except for the tip. A4352 reads “Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each” (short: “Coude tip urinary catheter”), effective 2026-01-01. A4351 is the straight tip; A4352 is the coude (curved) tip. Both are per-catheter units.
The FDA draws the same line. In the openFDA device classification data (last updated 2026-10-19), “Catheter, Straight” has product code EZD and “Catheter, Coude” has product code EZC, both under 21 CFR 876.5130 and both Class II.
A4353 and A4354: insertion supplies and trays
These two are easy to confuse with A4351 because the word “catheter” or “insertion” appears in each, but they describe different product bundles.
A4353
“Intermittent urinary catheter, with insertion supplies” (effective 2003-01-01). The descriptor bundles the catheter with insertion supplies, so it is not interchangeable with the catheter-only A4351 or A4352.
A4354
“Insertion tray with drainage bag but without catheter” (effective 1990-01-01). The phrase “but without catheter” matters: a tray coded A4354 does not include the catheter itself. A tray, kit and catheter are different line items; see the CASRAI urine collection kit guide for what such kits contain.
A4357 vs A4358: bedside bag vs leg or abdomen bag
A4357 is “Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each” (effective 1996-01-01). A4358 is “Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each” (effective 2002-01-01). The first is defined by where it sits (bedside); the second by where it is worn (leg or abdomen), by its vinyl material and by its straps. See what is a urinary drainage bag for the product itself.
Six-code cross-walk
| Code | CMS descriptor (condensed) | What differs | FDA product code |
|---|---|---|---|
| A4351 | Intermittent urinary catheter; straight tip, with or without coating, each | Straight tip, catheter only | EZD “Catheter, Straight” |
| A4352 | Intermittent urinary catheter; coude (curved) tip, with or without coating, each | Curved tip, catheter only | EZC “Catheter, Coude” |
| A4353 | Intermittent urinary catheter, with insertion supplies | Catheter bundled with insertion supplies | NWO “Kit, Catheter, Urinary” is the FDA’s kit category |
| A4354 | Insertion tray with drainage bag but without catheter | Tray and bag, no catheter | PPD “Universal Drainage Tray” and PPG “Urinary Drainage Collection Kit” are FDA tray and kit categories |
| A4357 | Bedside drainage bag, day or night, each | Bedside bag | Not mapped on this page |
| A4358 | Urinary drainage bag, leg or abdomen, vinyl, with straps, each | Leg or abdomen bag with straps | Not mapped on this page |
Sources for the table: CMS HCPCS Level II descriptors via the NLM Clinical Tables HCPCS API; FDA openFDA device classification, regulation number 876.5130. The FDA product codes are the agency’s own classification categories; the FDA does not publish them as equivalents of HCPCS codes, so read the last column as “nearest FDA category”, not a crosswalk issued by either agency.
How the FDA classifies these devices
21 CFR 876.5130 defines a urological catheter and accessories as “a flexible tubular device that is inserted through the urethra and used to pass fluids to or from the urinary tract.” The generic type expressly includes coude catheters and straight catheters, and the regulation classifies the device as Class II (performance standards). openFDA lists these product codes under 876.5130, all Class II: EZD (Catheter, Straight), EZC (Catheter, Coude), NWO (Kit, Catheter, Urinary), PPG (Urinary Drainage Collection Kit), PPD (Universal Drainage Tray) and GBM (Catheter, Urethral). A separate code, SHV “Reusable Intermittent Urinary Catheter System”, is Class II under 21 CFR 876.5120.
Safe use and handling basics
This page does not give insertion or technique instructions. The product’s instructions for use (IFU) and the treating clinician’s directions govern how a catheter is used. For handling at the supply level, a code’s descriptor is not a substitute for the IFU: coating, sterility, single-use status and size are set by the manufacturer’s labelling, not by the HCPCS code.
Common mistakes
- Treating the code as a size or brand. A4351 says “straight tip”; it does not specify gauge, length or manufacturer.
- Confusing a tray with a catheter. A4354 is defined as a tray with drainage bag “but without catheter”.
- Mixing up A4351 and A4352. The only difference is the tip: straight vs coude (curved).
- Confusing unit with box. Each of A4351, A4352, A4357 and A4358 is defined per “each”.
- Using an old descriptor. CMS updates the HCPCS file quarterly; the A4351 and A4352 wording above is effective 2026-01-01.
FAQ
What is A4351?
The HCPCS Level II code for an intermittent urinary catheter with a straight tip, with or without coating, per catheter.
What is the difference between A4351 and A4352?
Tip shape only: A4351 is straight, A4352 is coude (curved).
What does A4353 describe?
An intermittent urinary catheter together with insertion supplies.
What does A4354 describe?
An insertion tray with drainage bag but without the catheter.
What is the difference between A4357 and A4358?
A4357 is a bedside drainage bag for day or night use; A4358 is a vinyl leg or abdomen drainage bag with straps.
Related reading: Texas catheter and urology clinic supply checklist. Browse intermittent catheters at the lac.us catalogue.
Sources
- CMS, HCPCS Level II quarterly update page, https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system/quarterly-update (checked 2026-10-30).
- NLM Clinical Tables HCPCS API (CMS HCPCS data), https://clinicaltables.nlm.nih.gov/api/hcpcs/v3/search (checked 2026-10-30).
- FDA openFDA device classification, https://api.fda.gov/device/classification.json (regulation number 876.5130; data last updated 2026-10-19; checked 2026-10-30).
- 21 CFR 876.5130, https://www.law.cornell.edu/cfr/text/21/876.5130 (checked 2026-10-30).
