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Surgical stockings above knee length, each

HCPCS code

Surgical Stockings Above Knee Length, Each (A4490)

Name of the Procedure:

  • Common Names: Surgical Stockings, Compression Stockings
  • Technical Terms: Graduated Compression Stockings, Anti-embolism Stockings


Surgical stockings are special hosiery designed to improve blood flow in the legs. These compression stockings extend above the knee and are used to prevent blood clots, reduce swelling, and alleviate symptoms of conditions like varicose veins. They exert graduated pressure on the legs, being tightest at the ankle and gradually loosening higher up.


  • Medical Conditions Addressed:

    • Deep Vein Thrombosis (DVT)
    • Chronic Venous Insufficiency (CVI)
    • Varicose Veins
    • Lymphedema
    • Post-surgical swelling and pain
  • Goals:

    • Improve venous blood return
    • Decrease risk of blood clots
    • Reduce leg swelling and discomfort
    • Enhance overall leg circulation


  • Symptoms:

    • Swollen legs and feet
    • Leg pain or aching
    • Visible varicose veins
    • Risk factors for blood clots, such as prolonged bed rest or surgery
  • Patient Criteria:

    • Post-surgical patients
    • Individuals with poor circulation
    • Pregnant women experiencing leg swelling


  • Pre-procedure Instructions:

    • Measure legs for proper fitting
    • Ensure skin is clean and dry before wearing stockings
    • No specific fasting or medication adjustments needed
  • Assessments:

    • Doppler ultrasound to assess venous insufficiency (if needed)
    • Physical examination of legs

Procedure Description

  1. Measurement:
    • Measure ankle, calf, and thigh circumference, as well as leg length, to ensure proper fit.
  2. Application:
    • Sit or lie down to apply stockings.
    • Roll down the stocking to the heel.
    • Insert foot into the stocking first, then pull upward over the ankle, calf, and thigh.
  3. Adjustment:
    • Smooth out any wrinkles to ensure even compression.
    • Check that stockings feel snug but not too tight.
  • Tools/Equipment:

    • Graduated compression stockings (above knee length)
    • Tape measure
  • Anesthesia:

    • None required


  • Procedure Time:
    • 5-10 minutes for application


  • Locations:
    • Home
    • Outpatient clinic
    • Hospital


  • Involved Professionals:
    • Nurses
    • Healthcare assistants
    • Patient or caregiver at home

Risks and Complications

  • Common Risks:

    • Skin irritation or rashes
    • Discomfort from tightness
  • Rare Risks:

    • Deep Vein Thrombosis (if not used properly)
    • Allergic reactions to material


  • Expected Benefits:
    • Immediate reduction in leg swelling
    • Improved blood flow and reduced clot risk
    • Relief from pain and discomfort associated with varicose veins or lymphedema


  • Post-Procedure Care:

    • Wear stockings daily as directed
    • Remove stockings at night or as advised
  • Recovery Time:

    • Typically no recovery time needed; may experience immediate benefits
  • Follow-up:

    • Regular monitoring for skin changes or discomfort
    • Check-ups with healthcare provider to assess effectiveness


  • Other Options:

    • Oral anticoagulant medications
    • Pneumatic compression devices
    • Lifestyle changes (e.g., exercise, leg elevation)
  • Pros and Cons:

    • Medications may have systemic effects and require regular monitoring.
    • Pneumatic devices could be cumbersome for daily use compared to stockings.
    • Stockings are a non-invasive, straightforward method for immediate benefit.

Patient Experience

  • During Procedure:

    • Mild difficulty adjusting stockings initially
    • Some tightness but should feel supportive
  • After Procedure:

    • Possible mild discomfort as legs adjust
    • Regular use typically results in comfort and reduced symptoms
  • Pain Management:

    • Generally, no pain management necessary
    • Ensure proper fit to alleviate discomfort

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