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The Dish pessary is available from Monarch Medical Products, Inc. with or without a supporting membrane.  This pessary is used to relieve the stress of a second or third-degree uterine prolapse, a cystocele, or rectocele.  It may also relieve stress urinary incontinence.

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

  SKU # Description Price  
 
Dish Pessaries 1604050 Dish Pessary Without Support, 50mm #0 $45
 
 
Dish Pessaries 1604055 Dish Pessary Without Support, 55mm #1 $45
 
 
Dish Pessaries 1604060 Dish Pessary Without Support, 60mm #2 $45
 
 
Dish Pessaries 1604065 Dish Pessary Without Support, 65mm #3 $45
 
 
Dish Pessaries 1604070 Dish Pessary Without Support, 70mm #4 $45
 
 
Dish Pessaries 1604075 Dish Pessary Without Support, 75mm #5 $45
 
 
Dish Pessaries 1604080 Dish Pessary Without Support, 80mm #6 $45
 
 
Dish Pessaries 1604085 Dish Pessary Without Support, 85mm #7 $45
 
 
Dish Pessaries 1605050 Dish Pessary With Support, 50mm #0 $45
 
 
Dish Pessaries 1605055 Dish Pessary With Support, 55mm #1 $45
 
 
Dish Pessaries 1605060 Dish Pessary With Support, 60mm #2 $45
 
 
Dish Pessaries 1605065 Dish Pessary With Support, 65mm #3 $45
 
 
Dish Pessaries 1605070 Dish Pessary With Support, 70mm #4 $45
 
 
Dish Pessaries 1605075 Dish Pessary With Support, 75mm #5 $45
 
 
Dish Pessaries 1605080 Dish Pessary With Support, 80mm #6 $45
 
 
Dish Pessaries 1605085 Dish Pessary With Support, 85mm #7 $45
 
 
 
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For personal assistance, price quotes or volume discounts, please contact
Monarch Medical Products, Inc. via phone:
TOLL FREE 1-866-241-1625
or e-mail at sales@monarchmedicalproducts.com