A6216 HCPCS code: Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing

A6216 is the HCPCS Level II code for gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing. The 2026 Medicare DMEPOS fee schedule pays $0.05 to $0.09 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 fell 39% from 2022 to 2024 (5,664,348 to 3,445,150 services). In 2024, 765 suppliers billed Medicare for A6216 (purchases), serving 18,928 beneficiaries; Texas, Florida, California accounted for 25% of services. Its average fee ranks 1 of 41 A62 codes (family range $0.05–$56.30).

Code details

2026 Medicare DMEPOS fee schedule for A6216

How the A6216 fee compares

Who bills A6216 (2024)

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

Medicare utilization for A6216, 2022–2024

States with the most A6216 services (2024)

Medicare policy articles for this code

• A52521: Urological Supplies - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance

Covered diagnoses (1 ICD-10-CM codes)

The diagnoses most often listed as covered in the policy articles above:

What changed for A6216

• 1997-01-01: A6216 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 A6216?

A6216 is the HCPCS Level II code for gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing. Short descriptor: "Non-sterile gauze<=16 sq in".

How much does Medicare pay for A6216?

Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $0.05–$0.09. Rural fees can be higher.

Does Medicare cover A6216?

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

Which diagnoses support coverage for A6216?

Medicare policy articles that cite A6216 list 1 covered ICD-10-CM diagnosis codes across 1 article. The most cited include N39.3 (Stress incontinence (female) (male)). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.

Did the Medicare fee for A6216 change in 2026?

The average non-rural state fee moved from $0.05 in 2025 to $0.05 in 2026 (+0.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.

Related A62 codes

• A6203 — Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ($4.80–$5.70)
• A6204 — Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ($8.86–$10.62)
• A6205 — Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing
• A6206 — Contact layer, sterile, 16 sq. in. or less, each dressing
• A6207 — Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing ($10.47–$12.56)
• A6208 — Contact layer, sterile, more than 48 sq. in., each dressing
• A6209 — Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ($10.65–$12.82)
• A6210 — Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ($28.40–$34.06)
• A6211 — Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ($41.86–$50.18)
• A6212 — Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ($13.84–$16.61)
• A6213 — Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
• A6214 — Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing ($14.68–$17.62)

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Next steps

• Run a reimbursement report for a device billed under A6216
• Watch A6216 for fee, coverage and descriptor changes
• Build a full Medicare revenue model for A6216

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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