A6455 HCPCS code: Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard
A6455 is the HCPCS Level II code for self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard. The 2026 Medicare DMEPOS fee schedule pays $1.99 to $2.33 depending on the state. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 4 per day on outpatient hospital claims. Medicare volume rose 42% from 2022 to 2024 (19,226 to 27,263 services). In 2024, 38 suppliers billed Medicare for A6455 (purchases), serving 551 beneficiaries; New York, Florida, California accounted for 30% of services. Its average fee ranks 16 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 | C — Carrier judgment |
| Pricing indicator | 35 — DMEPOS: surgical dressings |
| BETOS category | D1A — Medical/surgical supplies |
| Added | 2004-01-01 |
| Last action effective | 2004-01-01 |
2026 Medicare DMEPOS fee schedule for A6455
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $1.99 | $2.33 | $1.99 | $1.69 |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $1.99 | — |
| AL | — | $1.99 | — |
| AR | — | $1.99 | — |
| AZ | — | $1.99 | — |
| CA | — | $1.99 | — |
| CO | — | $1.99 | — |
| CT | — | $1.99 | — |
| DC | — | $1.99 | — |
| DE | — | $1.99 | — |
| FL | — | $1.99 | — |
| GA | — | $1.99 | — |
| HI | — | $1.99 | — |
| IA | — | $1.99 | — |
| ID | — | $1.99 | — |
| IL | — | $1.99 | — |
| IN | — | $1.99 | — |
| KS | — | $1.99 | — |
| KY | — | $1.99 | — |
| LA | — | $1.99 | — |
| MA | — | $1.99 | — |
| MD | — | $1.99 | — |
| ME | — | $1.99 | — |
| MI | — | $1.99 | — |
| MN | — | $1.99 | — |
| MO | — | $1.99 | — |
| MS | — | $1.99 | — |
| MT | — | $1.99 | — |
| NC | — | $1.99 | — |
| ND | — | $1.99 | — |
| NE | — | $1.99 | — |
| NH | — | $1.99 | — |
| NJ | — | $1.99 | — |
| NM | — | $1.99 | — |
| NV | — | $1.99 | — |
| NY | — | $1.99 | — |
| OH | — | $1.99 | — |
| OK | — | $1.99 | — |
| OR | — | $1.99 | — |
| PA | — | $1.99 | — |
| PR | — | $2.33 | — |
| RI | — | $1.99 | — |
| SC | — | $1.99 | — |
| SD | — | $1.99 | — |
| TN | — | $1.99 | — |
| TX | — | $1.99 | — |
| UT | — | $1.99 | — |
| VA | — | $1.99 | — |
| VI | — | $1.99 | — |
| VT | — | $1.99 | — |
| WA | — | $1.99 | — |
| WI | — | $1.99 | — |
| WV | — | $1.99 | — |
| WY | — | $1.99 | — |
How the A6455 fee compares
| Measure | Value |
|---|---|
| Rank among 21 A64 codes (lowest = 1) | 16 |
| Family fee range (average of state fees) | $0.15–$8.43 |
| Rural fee uplift | — |
Who bills A6455 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 38 |
| Referring clinicians | 458 |
| Medicare beneficiaries | 551 |
| States with claims | 26 |
| Share of services in top 3 states (New York, Florida, California) | 30% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 36 | 403 |
| 2023 | 34 | 533 |
| 2024 | 38 | 551 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6455, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 19,226 | 403 | $1.69 | $1.32 |
| 2023 | 25,473 | 533 | $1.84 | $1.43 |
| 2024 | 27,263 | 551 | $1.89 | $1.47 |
States with the most A6455 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 3,144 | $1.44 |
| Florida | 2,430 | $1.47 |
| California | 1,894 | $1.49 |
| New Jersey | 1,760 | $1.49 |
| Texas | 1,581 | $1.49 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | 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 A6455
- 2026-01-01: Average state fee rose 2.1%: $1.96 to $2.00
- 2004-01-01: A6455 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 A6455?
A6455 is the HCPCS Level II code for self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard. Short descriptor: "Self-adher band >=5"/yd".
How much does Medicare pay for A6455?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $1.99–$2.33. Rural fees can be higher.
Does Medicare cover A6455?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A6455 change in 2026?
The average non-rural state fee moved from $1.96 in 2025 to $2.00 in 2026 (+2.1%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A6455 can be billed per day?
4 on outpatient hospital claims (NCCI medically unlikely edits).
Related A64 codes
- A6402 — Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ($0.15–$0.18)
- A6403 — Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing ($0.58–$0.73)
- 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)
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 A6455
- Watch A6455 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6455
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.