A6197 HCPCS code: 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

A6197 is the HCPCS Level II code for 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. The 2026 Medicare DMEPOS fee schedule pays $23.44 to $28.11 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 2414% from 2022 to 2024 (1,510,174 to 37,959,253 services). In 2024, 525 suppliers billed Medicare for A6197 (purchases), serving 119,489 beneficiaries; Maryland, Texas, Arizona accounted for 30% of services. Its average fee ranks 4 of 4 A61 codes (family range $7.56–$23.57).

Code details

2026 Medicare DMEPOS fee schedule for A6197

How the A6197 fee compares

Who bills A6197 (2024)

Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.

Medicare utilization for A6197, 2022–2024

States with the most A6197 services (2024)

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 A6197

• 2026-01-01: Average state fee rose 2.0%: $23.11 to $23.57
• 1997-01-01: A6197 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 A6197?

A6197 is the HCPCS Level II code for 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. Short descriptor: "Alginate drsg >16 <=48 sq in".

How much does Medicare pay for A6197?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $23.44–$28.11. Rural fees can be higher.

Does Medicare cover A6197?

Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.

Did the Medicare fee for A6197 change in 2026?

The average non-rural state fee moved from $23.11 in 2025 to $23.57 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)
• A6196 — Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing ($10.49–$12.59)
• 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)

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Next steps

• Run a reimbursement report for a device billed under A6197
• Watch A6197 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A6197

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.

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