Assura Original 2-piece urostomy pouch
ColoplastPouches2-pieceUrostomy
- Brand
- Coloplast
- Category
- Pouches
- System
- 2-piece
- Pouch type
- Urostomy
- Barrier type
- Not found in our sources
- Opening
- Not found in our sources
- Filter
- Not found in our sources
- Box quantity
- 10
- Flange sizes
- Coupling Blue, Coupling Green, Coupling Red
- HCPCS code(s)
- A4433 (Coloplast product page (variant name))
- Lowest cash price seen
- From $29.47 / Box of 10 ($2.95 each)
Vitality Medical, Nov 4, 2026 - Source
- products.coloplast.us · checked Nov 4, 2026
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Sizes, codes and prices
Prices are cash prices one retailer listed on the date shown, per the retailer's unit. Retailer links are marked as sponsored for search engines and may become affiliate links later. We do not take referral fees from suppliers that bill Medicare. The retailer page says the manufacturer labels this item Rx only.
| Code | Description / size | Box | HCPCS | Price seen |
|---|---|---|---|---|
1751 | Midi (9 1/2in / 150mL) - Coupling: Green Transparent | 10 per box | A4433 | — |
1752 | Midi (9 1/2in / 150mL) - Coupling: Red Transparent | 10 per box | A4433 | — |
1754 | Maxi (10 3/4in / 375mL) - Coupling: Green, Opaque | 10 per box | A4433 | — |
1755 | Maxi (10 3/4in / 375mL) - Coupling: Red Opaque | 10 per box | A4433 | — |
1756 | Maxi (10 3/4in / 375mL) - Coupling: Blue Opaque | 10 per box | A4433 | — |
1757 | Maxi (10 3/4in / 375mL) - Coupling: Green, Transparent | 10 per box | A4433 | — |
1758 | Maxi (10 3/4in / 375mL) - Coupling: Red, Transparent | 10 per box | A4433 | — |
1759 | Maxi (10 3/4in / 375mL) - Coupling: Blue Transparent | 10 per box | A4433 | — |
14204 | Urostomy micro-bag - 6in long - Coupling: Green, Transparent | 10 per box | A4433 | $53.03 / Box of 10 Vitality Medical · Nov 4, 2026$30.45 / Box of 5 Vitality Medical · Nov 4, 2026 |
14205 | Urostomy micro-bag - 6in long - Coupling: Red, Transparent | 10 per box | A4433 | $53.03 / Box of 10 Vitality Medical · Nov 4, 2026 |
14206 | Urostomy micro bag - 6in long - Coupling: Blue, Transparent | 10 per box | A4433 | $50.85 / Box of 10 Vitality Medical · Nov 4, 2026 |
14224 | Maxi (10 1/2in / 488mL) - Coupling: Green Pouch: White | 10 per box | A4433 | $42.95 / Box of 10 Vitality Medical · Nov 4, 2026 |
14225 | Maxi (10 1/2in / 488mL) - Coupling: Red Pouch: White | 10 per box | A4433 | $39.88 / Box of 10 Vitality Medical · Nov 4, 2026 |
14226 | Maxi (10 1/2in / 488mL) - Coupling: Blue Pouch: White | 10 per box | A4433 | $29.47 / Box of 10 Vitality Medical · Nov 4, 2026 |
14227 | Maxi (10 1/2in / 488mL) - Coupling: Green Transparent | 10 per box | A4433 | $42.95 / Box of 10 Vitality Medical · Nov 4, 2026 |
14228 | Maxi (10 1/2in / 488mL) - Coupling: Red Transparent | 10 per box | A4433 | $42.95 / Box of 10 Vitality Medical · Nov 4, 2026 |
14229 | Maxi (10 1/2in / 488mL) - Coupling: Blue, Transparent | 10 per box | A4433 | $4.18 / Each Vitality Medical · Nov 4, 2026$41.47 / Box of 10 Vitality Medical · Nov 4, 2026 |
Medicare usual maximums for these codes
- A4433: Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each. Usual maximum in LCD L33828: 20 per month.
From our Medicare guide (LCD L33828). Informational only; coverage depends on your plan and documentation. Confirm with your supplier or plan.
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