Assura 2-piece stoma cap
ColoplastPouches2-pieceStoma cap
- Brand
- Coloplast
- Category
- Pouches
- System
- 2-piece
- Pouch type
- Stoma cap
- Barrier type
- Not found in our sources
- Opening
- Not found in our sources
- Filter
- Yes
- Box quantity
- 30
- Flange sizes
- Coupling Blue, Coupling Green, Coupling Red
- HCPCS code(s)
- A4414, A5055 (Coloplast product page (variant name))
- Lowest cash price seen
- No sourced price yet
- 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.
| Code | Description / size | Box | HCPCS | Price seen |
|---|---|---|---|---|
2801 | Minicap 2-piece - Coupling: Green - with filter, Opaque | 30 per box | A5055 | — |
2802 | Minicap 2-piece - Coupling: Red - with filter Opaque | 30 per box | A5055 | — |
2803 | Stoma Cap - Coupling: Blue - with filter, Opaque | 30 per box | A5055 | — |
2807 | Urostomy minicap - 100mL - Coupling: Green Opaque | 30 per box | A5055 | — |
2808 | Urostomy Minicap - 100mL - Coupling: Red Opaque | 30 per box | A4414 | — |
Medicare usual maximums for these codes
- A4414: Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each. Usual maximum in LCD L33828: 20 per month.
- 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.