Monarch Medical Products

The malleable Hodge pessary, available with or without a supporting membrane, is commonly used for a first or mild second-degree uterine prolapse and may also relieve a cystocele. These pessaries, designed to be manually shapeable for individual fitting, are usually prescribed for reproductive-aged women who prefer conservative therapy.

HCPCS Reimbursement Code for Pessary - A4562
Code for Office Visit - 99214
CPT Code for Fitting & Insertion - 57160

SKU #	Description	Price
1613065	Hodge Pessary Without Support, 65mm #0	$45
1613070	Hodge Pessary Without Support, 70mm #1	$45
1613075	Hodge Pessary Without Support, 75mm #2	$45
1613080	Hodge Pessary Without Support, 80mm #3	$45
1613085	Hodge Pessary Without Support, 85mm #4	$45
1613090	Hodge Pessary Without Support, 90mm #5	$45
1613095	Hodge Pessary Without Support, 95mm #6	$45
1613100	Hodge Pessary Without Support, 100mm #7	$45
1613105	Hodge Pessary Without Support, 105mm #8	$45
1613110	Hodge Pessary Without Support, 110mm #9	$45
1614065	Hodge Pessary With Support, 65mm #0	$45
1614070	Hodge Pessary With Support, 70mm #1	$45
1614075	Hodge Pessary With Support, 75mm #2	$45
1614080	Hodge Pessary With Support, 80mm #3	$45
1614085	Hodge Pessary With Support, 85mm #4	$45
1614090	Hodge Pessary With Support, 90mm #5	$45
1614095	Hodge Pessary With Support, 95mm #6	$45
1614100	Hodge Pessary With Support, 100mm #7	$45
1614105	Hodge Pessary With Support, 105mm #8	$45
1614110	Hodge Pessary With Support, 110mm #9	$45