SenSura Mio Convex Deep 1-piece drainable pouch
ColoplastPouches1-pieceDrainableConvex
- Brand
- Coloplast
- Category
- Pouches
- System
- 1-piece
- Pouch type
- Drainable
- Barrier type
- Convex (from product name)
- Opening
- Not found in our sources
- Filter
- Some variants
- Box quantity
- 10
- Flange sizes
- Not found in our sources
- HCPCS code(s)
- A4390, A5057 (Coloplast product page (variant name))
- Lowest cash price seen
- From $89.48 / Box of 10 ($8.95 each)
Vitality Medical, Nov 4, 2026 - Source
- products.coloplast.us · checked Nov 4, 2026
Add to Supply Planner Compare with similar
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 |
|---|---|---|---|---|
16755 | Maxi (11in / 655mL) - Stoma size: 10-22mm | 3/8 - 7/8in - with filter, Opaque gray | 10 per box | A5057 | $89.70 / Box of 10 Vitality Medical · Nov 4, 2026 |
16756 | Maxi (11in / 655mL) - Stoma size: 15-33mm | 5/8 - 1 5/16in - with filter, Opaque gray | 10 per box | A5057 | $92.37 / Box of 10 Vitality Medical · Nov 4, 2026 |
16757 | Maxi (11in / 655mL) - Stoma size: 31mm | 1 1/4in - with filter, Opaque gray | 10 per box | A5057 | — |
16760 | Maxi (11in / 655mL) - Stoma size: 21mm | 13/16in - with filter, Opaque gray | 10 per box | A5057 | $89.73 / Box of 10 Vitality Medical · Nov 4, 2026 |
16761 | Maxi (11in / 655mL) - Stoma size: 25mm | 1in - with filter, Opaque gray | 10 per box | A5057 | $89.73 / Box of 10 Vitality Medical · Nov 4, 2026 |
16762 | Maxi (11in / 655mL) - Stoma size: 28mm | 1 1/8in - with filter, Opaque gray | 10 per box | A5057 | $89.70 / Box of 10 Vitality Medical · Nov 4, 2026 |
16763 | Maxi (11in / 655mL) - Stoma size: 35mm | 1 3/8in - with filter, Opaque gray | 10 per box | A5057 | $89.48 / Box of 10 Vitality Medical · Nov 4, 2026 |
16764 | Maxi (11in / 655mL) - Stoma size: 38mm | 1 1/2in - with filter, Opaque gray | 10 per box | A5057 | $89.70 / Box of 10 Vitality Medical · Nov 4, 2026 |
16765 | Maxi (11in / 655mL) - Stoma size: 10-22mm | 3/8 - 7/8in - with filter, Transparent | 10 per box | A5057 | $92.39 / Box of 10 Vitality Medical · Nov 4, 2026 |
16766 | Maxi (11in / 655mL) - Stoma size: 15-33mm | 5/8 - 1 5/16in - with filter, Transparent | 10 per box | A5057 | $91.62 / Box of 10 Vitality Medical · Nov 4, 2026 |
16767 | Maxi (11in / 655mL) - Stoma size: 10-43mm | 3/8 - 1 11/16in - with filter, Transparent | 10 per box | A5057 | $100.67 / Box of 10 Vitality Medical · Nov 4, 2026 |
16768 | Maxi (11in / 655mL) - Stoma size: 10-43mm | 3/8 - 1 11/16in - with filter, Opaque gray | 10 per box | A5057 | $91.30 / Box of 10 Vitality Medical · Nov 4, 2026 |
16770 | Maxi (11in / 655mL) - Stoma size: 21mm | 13/16in - with filter, Transparent | 10 per box | A5057 | $103.70 / Box of 10 Vitality Medical · Nov 4, 2026 |
16771 | Maxi (11in / 655mL) - Stoma size: 25mm | 1in - with filter, Transparent | 10 per box | A5057 | $93.34 / Box of 10 Vitality Medical · Nov 4, 2026 |
16772 | Maxi (11in / 655mL) - Stoma size: 28mm | 1 1/8in - with filter, Transparent | 10 per box | A5057 | $99.25 / Box of 10 Vitality Medical · Nov 4, 2026 |
16773 | Maxi (11in / 655mL) - Stoma size: 31mm | 1 1/4in - with filter, Transparent | 10 per box | A5057 | $89.68 / Box of 10 Vitality Medical · Nov 4, 2026 |
16778 | Maxi (11in / 655mL) - Stoma size: 10-43mm | 3/8 - 1 11/16in - no filter, Transparent | 10 per box | A4390 | $94.16 / Box of 10 Vitality Medical · Nov 4, 2026 |
18984 | , Maxi - Stoma size: 3/8 - 7/8in (10-23mm), with filter, Opaque black | 10 per box | A5057 | — |
18985 | , Maxi - Stoma size: 5/8 - 1 5/16in (15-33mm), with filter, Opaque black | 10 per box | A5057 | — |
18986 | , Maxi - Stoma size: 3/8 - 1 11/16in (10-43mm), with filter, Opaque black | 10 per box | A5057 | — |
Medicare usual maximums for these codes
- A4390: Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each. No usual maximum is listed for this code in the LCD table.
- A5057: Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each. Usual maximum in LCD L33828: 40 per month.
From our Medicare guide (LCD L33828). Informational only; coverage depends on your plan and documentation. Confirm with your supplier or plan.
Similar products
Convatec
Esteem+ One-Piece Convex Drainable Pouch
Pouches1-pieceDrainableConvexFrom $121.73 / Box of 10 ($12.17 each)
Convatec
ActiveLife One-Piece Convex Drainable Pouch
Pouches1-pieceDrainableConvexNo sourced price yet
Hollister
Premier One-Piece Drainable Ostomy Pouch – Convex CeraPlus Barrier, Lock 'n Roll Microseal Closure, Tape
Pouches1-pieceDrainableConvexNo sourced price yet
Hollister
Premier One-Piece Drainable Ostomy Pouch – Convex CeraPlus Barrier, Lock 'n Roll Microseal Closure, Tape, Filter
Pouches1-pieceDrainableConvexNo sourced price yet
Coloplast
Assura Convex Deep 1-piece drainable pouch
Pouches1-pieceDrainableConvexFrom $38.97 / Box of 5 ($7.79 each)
Coloplast
SenSura Convex Light 1-piece drainable pouch (including Xpro extended wear)
Pouches1-pieceDrainableConvexFrom $71.50 / Box of 10 ($7.15 each)