A6259 HCPCS code: Transparent film, sterile, more than 48 sq. in., each dressing
A6259 is the HCPCS Level II code for transparent film, sterile, more than 48 sq. in., each dressing. The 2026 Medicare DMEPOS fee schedule pays $15.59 to $18.71 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. The NCCI unit limit is 3 per day on outpatient hospital claims. Medicare volume fell 73% from 2022 to 2024 (14,986 to 4,100 services). In 2024, 43 suppliers billed Medicare for A6259 (purchases), serving 142 beneficiaries; New York, New Jersey, Massachusetts accounted for 65% of services. Its average fee ranks 30 of 41 A62 codes (family range $0.05–$56.30).
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 A6259
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $15.59 | $18.71 | $15.59 | $13.25 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $15.75 | — |
| AL | — | $15.59 | — |
| AR | — | $15.59 | — |
| AZ | — | $15.59 | — |
| CA | — | $15.59 | — |
| CO | — | $15.59 | — |
| CT | — | $15.59 | — |
| DC | — | $15.59 | — |
| DE | — | $15.59 | — |
| FL | — | $15.59 | — |
| GA | — | $15.59 | — |
| HI | — | $16.84 | — |
| IA | — | $15.59 | — |
| ID | — | $15.59 | — |
| IL | — | $15.59 | — |
| IN | — | $15.59 | — |
| KS | — | $15.59 | — |
| KY | — | $15.59 | — |
| LA | — | $15.59 | — |
| MA | — | $15.59 | — |
| MD | — | $15.59 | — |
| ME | — | $15.59 | — |
| MI | — | $15.59 | — |
| MN | — | $15.59 | — |
| MO | — | $15.59 | — |
| MS | — | $15.59 | — |
| MT | — | $15.59 | — |
| NC | — | $15.59 | — |
| ND | — | $15.59 | — |
| NE | — | $15.59 | — |
| NH | — | $15.59 | — |
| NJ | — | $15.59 | — |
| NM | — | $15.59 | — |
| NV | — | $15.59 | — |
| NY | — | $15.59 | — |
| OH | — | $15.59 | — |
| OK | — | $15.59 | — |
| OR | — | $15.59 | — |
| PA | — | $15.59 | — |
| PR | — | $18.71 | — |
| RI | — | $15.59 | — |
| SC | — | $15.59 | — |
| SD | — | $15.59 | — |
| TN | — | $15.59 | — |
| TX | — | $15.59 | — |
| UT | — | $15.59 | — |
| VA | — | $15.59 | — |
| VI | — | $15.59 | — |
| VT | — | $15.59 | — |
| WA | — | $15.59 | — |
| WI | — | $15.59 | — |
| WV | — | $15.59 | — |
| WY | — | $15.59 | — |
How the A6259 fee compares
| Measure | Value |
|---|---|
| Rank among 41 A62 codes (lowest = 1) | 30 |
| Family fee range (average of state fees) | $0.05–$56.30 |
| Rural fee uplift | — |
Who bills A6259 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 43 |
| Referring clinicians | 136 |
| Medicare beneficiaries | 142 |
| States with claims | 10 |
| Share of services in top 3 states (New York, New Jersey, Massachusetts) | 65% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 69 | 321 |
| 2023 | 47 | 177 |
| 2024 | 43 | 142 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6259, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 14,986 | 321 | $13.33 | $10.39 |
| 2023 | 6,312 | 177 | $14.48 | $11.27 |
| 2024 | 4,100 | 142 | $14.10 | $10.98 |
States with the most A6259 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 1,133 | $10.18 |
| New Jersey | 511 | $11.69 |
| Massachusetts | 322 | $11.70 |
| Texas | 285 | $10.25 |
| Illinois | 201 | $11.70 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3 | Clinical: Data |
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 A6259
- 2026-01-01: Average state fee rose 2.0%: $15.36 to $15.68
- 1997-01-01: A6259 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 A6259?
A6259 is the HCPCS Level II code for transparent film, sterile, more than 48 sq. in., each dressing. Short descriptor: "Transparent film > 48 sq in".
How much does Medicare pay for A6259?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $15.59–$18.71. Rural fees can be higher.
Does Medicare cover A6259?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A6259 change in 2026?
The average non-rural state fee moved from $15.36 in 2025 to $15.68 in 2026 (+2.0%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A6259 can be billed per day?
3 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)
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 A6259
- Watch A6259 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6259
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.