A6154 HCPCS code: Wound pouch, each
A6154 is the HCPCS Level II code for wound pouch, each. The 2026 Medicare DMEPOS fee schedule pays $19.86 to $22.46 depending on the state. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1 per day on outpatient hospital claims. Medicare volume fell 10% from 2022 to 2024 (5,800 to 5,205 services). In 2024, 51 suppliers billed Medicare for A6154 (purchases), serving 98 beneficiaries; Washington, West Virginia, Pennsylvania accounted for 33% of services. Its average fee ranks 3 of 4 A61 codes (family range $7.56–$23.57).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 35 — DMEPOS: surgical dressings |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 1997-01-01 |
| Last action effective | 2003-01-01 |
2026 Medicare DMEPOS fee schedule for A6154
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $19.86 | $22.46 | $20.49 | $17.42 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $20.62 | — |
| AL | — | $20.49 | — |
| AR | — | $20.49 | — |
| AZ | — | $20.47 | — |
| CA | — | $20.47 | — |
| CO | — | $20.49 | — |
| CT | — | $20.49 | — |
| DC | — | $19.86 | — |
| DE | — | $20.49 | — |
| FL | — | $19.86 | — |
| GA | — | $20.49 | — |
| HI | — | $22.09 | — |
| IA | — | $20.47 | — |
| ID | — | $20.47 | — |
| IL | — | $19.86 | — |
| IN | — | $20.49 | — |
| KS | — | $20.47 | — |
| KY | — | $20.49 | — |
| LA | — | $20.49 | — |
| MA | — | $20.49 | — |
| MD | — | $19.86 | — |
| ME | — | $20.49 | — |
| MI | — | $20.49 | — |
| MN | — | $20.49 | — |
| MO | — | $20.47 | — |
| MS | — | $20.49 | — |
| MT | — | $20.47 | — |
| NC | — | $20.47 | — |
| ND | — | $20.47 | — |
| NE | — | $20.47 | — |
| NH | — | $20.49 | — |
| NJ | — | $20.49 | — |
| NM | — | $20.49 | — |
| NV | — | $20.47 | — |
| NY | — | $20.49 | — |
| OH | — | $19.86 | — |
| OK | — | $20.49 | — |
| OR | — | $20.47 | — |
| PA | — | $20.49 | — |
| PR | — | $22.46 | — |
| RI | — | $20.49 | — |
| SC | — | $20.49 | — |
| SD | — | $20.47 | — |
| TN | — | $20.49 | — |
| TX | — | $19.86 | — |
| UT | — | $20.47 | — |
| VA | — | $19.86 | — |
| VI | — | $20.49 | — |
| VT | — | $20.49 | — |
| WA | — | $20.47 | — |
| WI | — | $20.49 | — |
| WV | — | $19.86 | — |
| WY | — | $20.47 | — |
How the A6154 fee compares
| Measure | Value |
|---|---|
| Rank among 4 A61 codes (lowest = 1) | 3 |
| Family fee range (average of state fees) | $7.56–$23.57 |
| Rural fee uplift | — |
Who bills A6154 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 51 |
| Referring clinicians | 106 |
| Medicare beneficiaries | 98 |
| States with claims | 15 |
| Share of services in top 3 states (Washington, West Virginia, Pennsylvania) | 33% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 55 | 114 |
| 2023 | 42 | 86 |
| 2024 | 51 | 98 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6154, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 5,800 | 114 | $17.35 | $13.33 |
| 2023 | 5,014 | 86 | $18.84 | $14.41 |
| 2024 | 5,205 | 98 | $19.34 | $14.94 |
States with the most A6154 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Washington | 479 | $14.98 |
| West Virginia | 430 | $14.54 |
| Pennsylvania | 330 | $14.92 |
| Virginia | 275 | $14.36 |
| North Carolina | 270 | $14.97 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Clinical: CMS Workgroup |
Medicare policy articles for this code
- A54563: Surgical Dressings - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
What changed for A6154
- 2026-01-01: Average state fee rose 2.0%: $20.06 to $20.46
- 1997-01-01: A6154 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A6154?
A6154 is the HCPCS Level II code for wound pouch, each. Short descriptor: "Wound pouch each".
How much does Medicare pay for A6154?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $19.86–$22.46. Rural fees can be higher.
Does Medicare cover A6154?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A6154 change in 2026?
The average non-rural state fee moved from $20.06 in 2025 to $20.46 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A6154 can be billed per day?
1 on outpatient hospital claims (NCCI medically unlikely edits).
Related A61 codes
- A6196 — Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing ($10.49–$12.59)
- A6197 — Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ($23.44–$28.11)
- A6198 — Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing
- A6199 — Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches ($7.52–$8.99)
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under A6154
- Watch A6154 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6154
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.