A6261 HCPCS code: Wound filler, gel/paste, per fluid ounce, not otherwise specified
A6261 is the HCPCS Level II code for wound filler, gel/paste, per fluid ounce, not otherwise specified. In 2024 Medicare paid an average of $48.09 per service for A6261 across 8,652 services. 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 3% from 2022 to 2024 (8,892 to 8,652 services). In 2024, 72 suppliers billed Medicare for A6261 (purchases), serving 3,142 beneficiaries; California, New York, Pennsylvania accounted for 23% of services.
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 | 2011-01-01 |
Who bills A6261 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 72 |
| Referring clinicians | 1,370 |
| Medicare beneficiaries | 3,142 |
| States with claims | 40 |
| Share of services in top 3 states (California, New York, Pennsylvania) | 23% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 118 | 3,324 |
| 2023 | 93 | 3,405 |
| 2024 | 72 | 3,142 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6261, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 8,892 | 3,324 | $53.71 | $42.08 |
| 2023 | 9,024 | 3,405 | $60.48 | $47.00 |
| 2024 | 8,652 | 3,142 | $61.70 | $48.09 |
States with the most A6261 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 766 | $80.68 |
| New York | 631 | $59.89 |
| Pennsylvania | 523 | $10.09 |
| Tennessee | 476 | $47.10 |
| Massachusetts | 448 | $83.63 |
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 A6261
- 1997-01-01: A6261 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 A6261?
A6261 is the HCPCS Level II code for wound filler, gel/paste, per fluid ounce, not otherwise specified. Short descriptor: "Wound filler gel/paste /oz".
How much does Medicare pay for A6261?
In 2024, the average Medicare payment was $48.09 per service (average allowed $61.70).
Does Medicare cover A6261?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of A6261 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 A6261
- Watch A6261 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6261
Sources: CMS HCPCS Level II release October 2026; 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.