A6403 HCPCS code: Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing
A6403 is the HCPCS Level II code for gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing. The 2026 Medicare DMEPOS fee schedule pays $0.58 to $0.73 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. Its average fee ranks 7 of 21 A64 codes (family range $0.15–$8.43).
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 |
2026 Medicare DMEPOS fee schedule for A6403
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $0.58 | $0.73 | $0.58 | $0.49 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $0.62 | — |
| AL | — | $0.58 | — |
| AR | — | $0.58 | — |
| AZ | — | $0.58 | — |
| CA | — | $0.58 | — |
| CO | — | $0.58 | — |
| CT | — | $0.58 | — |
| DC | — | $0.58 | — |
| DE | — | $0.58 | — |
| FL | — | $0.58 | — |
| GA | — | $0.58 | — |
| HI | — | $0.67 | — |
| IA | — | $0.58 | — |
| ID | — | $0.58 | — |
| IL | — | $0.58 | — |
| IN | — | $0.58 | — |
| KS | — | $0.58 | — |
| KY | — | $0.58 | — |
| LA | — | $0.58 | — |
| MA | — | $0.58 | — |
| MD | — | $0.58 | — |
| ME | — | $0.58 | — |
| MI | — | $0.58 | — |
| MN | — | $0.58 | — |
| MO | — | $0.58 | — |
| MS | — | $0.58 | — |
| MT | — | $0.58 | — |
| NC | — | $0.58 | — |
| ND | — | $0.58 | — |
| NE | — | $0.58 | — |
| NH | — | $0.58 | — |
| NJ | — | $0.58 | — |
| NM | — | $0.58 | — |
| NV | — | $0.58 | — |
| NY | — | $0.58 | — |
| OH | — | $0.58 | — |
| OK | — | $0.58 | — |
| OR | — | $0.58 | — |
| PA | — | $0.58 | — |
| PR | — | $0.73 | — |
| RI | — | $0.58 | — |
| SC | — | $0.58 | — |
| SD | — | $0.58 | — |
| TN | — | $0.58 | — |
| TX | — | $0.58 | — |
| UT | — | $0.58 | — |
| VA | — | $0.58 | — |
| VI | — | $0.58 | — |
| VT | — | $0.58 | — |
| WA | — | $0.58 | — |
| WI | — | $0.58 | — |
| WV | — | $0.58 | — |
| WY | — | $0.58 | — |
How the A6403 fee compares
| Measure | Value |
|---|---|
| Rank among 21 A64 codes (lowest = 1) | 7 |
| Family fee range (average of state fees) | $0.15–$8.43 |
| Rural fee uplift | — |
What changed for A6403
- 2026-01-01: Average state fee rose 1.7%: $0.58 to $0.59
- 1997-01-01: A6403 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 A6403?
A6403 is the HCPCS Level II code for gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing. Short descriptor: "Sterile gauze>16 <= 48 sq in".
How much does Medicare pay for A6403?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $0.58–$0.73. Rural fees can be higher.
Does Medicare cover A6403?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Did the Medicare fee for A6403 change in 2026?
The average non-rural state fee moved from $0.58 in 2025 to $0.59 in 2026 (+1.7%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
Related A64 codes
- A6402 — Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ($0.15–$0.18)
- A6404 — Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing
- A6407 — Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard ($2.66–$3.21)
- A6410 — Eye pad, sterile, each ($0.53–$0.68)
- A6411 — Eye pad, non-sterile, each
- A6412 — Eye patch, occlusive, each
- A6413 — Adhesive bandage, first-aid type, any size, each
- A6441 — Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard ($0.97–$1.16)
- A6442 — Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard ($0.23–$0.35)
- A6443 — Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard ($0.40–$0.48)
- A6444 — Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard ($0.80–$0.99)
- A6445 — Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard ($0.45–$0.51)
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Next steps
- Run a reimbursement report for a device billed under A6403
- Watch A6403 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6403
Sources: CMS HCPCS Level II release October 2025; 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.