A6217 HCPCS code: Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
A6217 is the HCPCS Level II code for gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing. In 2024 Medicare paid an average of $0.48 per service for A6217 across 30,248 services. 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 43% from 2022 to 2024 (21,089 to 30,248 services). In 2024, 32 suppliers billed Medicare for A6217 (purchases), serving 427 beneficiaries; Minnesota, New York, Massachusetts accounted for 53% of services.
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 |
Who bills A6217 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 32 |
| Referring clinicians | 321 |
| Medicare beneficiaries | 427 |
| States with claims | 15 |
| Share of services in top 3 states (Minnesota, New York, Massachusetts) | 53% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 35 | 239 |
| 2023 | 32 | 386 |
| 2024 | 32 | 427 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6217, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 21,089 | 239 | $0.35 | $0.27 |
| 2023 | 30,902 | 386 | $0.17 | $0.13 |
| 2024 | 30,248 | 427 | $0.62 | $0.48 |
States with the most A6217 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Minnesota | 6,369 | $0.07 |
| New York | 3,723 | $2.92 |
| Massachusetts | 3,224 | $0.21 |
| Kentucky | 2,312 | $0.07 |
| Indiana | 1,677 | $0.07 |
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
- A54563: Surgical Dressings - 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:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| N39.3 | Stress incontinence (female) (male) | 1 |
What changed for A6217
- 1997-01-01: A6217 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 A6217?
A6217 is the HCPCS Level II code for gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing. Short descriptor: "Non-sterile gauze>16<=48 sq".
How much does Medicare pay for A6217?
In 2024, the average Medicare payment was $0.48 per service (average allowed $0.62).
Does Medicare cover A6217?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for A6217?
Medicare policy articles that cite A6217 list 1 covered ICD-10-CM diagnosis codes across 2 articles. 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.
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)
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 A6217
- Watch A6217 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6217
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; 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.