A6228 HCPCS code: Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing
A6228 is the HCPCS Level II code for gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing. 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 2 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 46 — Priced by the Medicare contractor (no national fee) |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 1997-01-01 |
| Last action effective | 2009-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | 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 A6228
- 1997-01-01: A6228 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 A6228?
A6228 is the HCPCS Level II code for gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing. Short descriptor: "Gauze <= 16 sq in water/sal".
Does Medicare cover A6228?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of A6228 can be billed per day?
2 on outpatient hospital claims (NCCI medically unlikely edits).
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 A6228
- Watch A6228 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6228
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.