A6196 HCPCS code: Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing
A6196 is the HCPCS Level II code for alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing. The 2026 Medicare DMEPOS fee schedule pays $10.49 to $12.59 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. Medicare volume rose 14% from 2022 to 2024 (5,310,726 to 6,076,308 services). In 2024, 542 suppliers billed Medicare for A6196 (purchases), serving 87,704 beneficiaries; Florida, Texas, California accounted for 29% of services. Its average fee ranks 2 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 | 2009-01-01 |
2026 Medicare DMEPOS fee schedule for A6196
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $10.49 | $12.59 | $10.49 | $8.92 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $10.57 | — |
| AL | — | $10.49 | — |
| AR | — | $10.49 | — |
| AZ | — | $10.49 | — |
| CA | — | $10.49 | — |
| CO | — | $10.49 | — |
| CT | — | $10.49 | — |
| DC | — | $10.49 | — |
| DE | — | $10.49 | — |
| FL | — | $10.49 | — |
| GA | — | $10.49 | — |
| HI | — | $11.30 | — |
| IA | — | $10.49 | — |
| ID | — | $10.49 | — |
| IL | — | $10.49 | — |
| IN | — | $10.49 | — |
| KS | — | $10.49 | — |
| KY | — | $10.49 | — |
| LA | — | $10.49 | — |
| MA | — | $10.49 | — |
| MD | — | $10.49 | — |
| ME | — | $10.49 | — |
| MI | — | $10.49 | — |
| MN | — | $10.49 | — |
| MO | — | $10.49 | — |
| MS | — | $10.49 | — |
| MT | — | $10.49 | — |
| NC | — | $10.49 | — |
| ND | — | $10.49 | — |
| NE | — | $10.49 | — |
| NH | — | $10.49 | — |
| NJ | — | $10.49 | — |
| NM | — | $10.49 | — |
| NV | — | $10.49 | — |
| NY | — | $10.49 | — |
| OH | — | $10.49 | — |
| OK | — | $10.49 | — |
| OR | — | $10.49 | — |
| PA | — | $10.49 | — |
| PR | — | $12.59 | — |
| RI | — | $10.49 | — |
| SC | — | $10.49 | — |
| SD | — | $10.49 | — |
| TN | — | $10.49 | — |
| TX | — | $10.49 | — |
| UT | — | $10.49 | — |
| VA | — | $10.49 | — |
| VI | — | $10.49 | — |
| VT | — | $10.49 | — |
| WA | — | $10.49 | — |
| WI | — | $10.49 | — |
| WV | — | $10.49 | — |
| WY | — | $10.49 | — |
How the A6196 fee compares
| Measure | Value |
|---|---|
| Rank among 4 A61 codes (lowest = 1) | 2 |
| Family fee range (average of state fees) | $7.56–$23.57 |
| Rural fee uplift | — |
Who bills A6196 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 542 |
| Referring clinicians | 17,859 |
| Medicare beneficiaries | 87,704 |
| States with claims | 55 |
| Share of services in top 3 states (Florida, Texas, California) | 29% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 779 | 77,552 |
| 2023 | 644 | 84,754 |
| 2024 | 542 | 87,704 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6196, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 5,310,726 | 77,552 | $9.00 | $7.01 |
| 2023 | 5,434,406 | 84,754 | $9.75 | $7.56 |
| 2024 | 6,076,308 | 87,704 | $9.98 | $7.77 |
States with the most A6196 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 794,949 | $7.74 |
| Texas | 547,039 | $7.82 |
| California | 445,509 | $7.82 |
| New York | 435,143 | $7.63 |
| Pennsylvania | 315,915 | $7.71 |
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 A6196
- 2026-01-01: Average state fee rose 2.0%: $10.34 to $10.55
- 1997-01-01: A6196 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 A6196?
A6196 is the HCPCS Level II code for alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing. Short descriptor: "Alginate dressing <=16 sq in".
How much does Medicare pay for A6196?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $10.49–$12.59. Rural fees can be higher.
Does Medicare cover A6196?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A6196 change in 2026?
The average non-rural state fee moved from $10.34 in 2025 to $10.55 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
Related A61 codes
- A6154 — Wound pouch, each ($19.86–$22.46)
- 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 A6196
- Watch A6196 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6196
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.