ActiveLife One-Piece Stoma Cap
ConvatecPouches1-pieceStoma capFlat
- Brand
- Convatec
- Category
- Pouches
- System
- 1-piece
- Pouch type
- Stoma cap
- Barrier type
- Flat (from product name)
- Opening
- Cut-to-fit
- Filter
- Yes
- Box quantity
- 30
- Flange sizes
- Not found in our sources
- HCPCS code(s)
- A5055 (Convatec product page (ordering table))
- Lowest cash price seen
- No sourced price yet
- Source
- convatec.com · 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.
| Code | Description / size | Box | HCPCS | Price seen |
|---|---|---|---|---|
175611 | Cut-to-fit, Stomahesive Skin Barrier and no tape collar; stoma cap with 1-sided comfort panel and filter — Opaque | 30 per box | A5055 | — |
Medicare usual maximums for these codes
- A5055: Stoma cap. Usual maximum in LCD L33828: 31 per month.
From our Medicare guide (LCD L33828). Informational only; coverage depends on your plan and documentation. Confirm with your supplier or plan.