A6509 HCPCS code: Compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated
A6509 is the HCPCS Level II code for compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated. In 2024 Medicare paid an average of $558.50 per service for A6509 across 27 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 2 per day on DME suppliers. Medicare volume fell 25% from 2022 to 2024 (36 to 27 services). In 2024, 8 suppliers billed Medicare for A6509 (purchases), serving 13 beneficiaries.
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 | 2003-01-01 |
| Last action effective | 2003-01-01 |
Who bills A6509 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 8 |
| Referring clinicians | 13 |
| Medicare beneficiaries | 13 |
| States with claims | 0 |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 10 | 17 |
| 2023 | 8 | 30 |
| 2024 | 8 | 13 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6509, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 36 | 17 | $668.76 | $517.82 |
| 2023 | 50 | 30 | $408.14 | $315.86 |
| 2024 | 27 | 13 | $712.37 | $558.50 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 2 | Nature of Equipment |
| outpatient hospital claims | 1 | Nature of Equipment |
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 A6509
- 2003-01-01: A6509 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 A6509?
A6509 is the HCPCS Level II code for compression burn garment, upper trunk to waist including arm openings (vest), custom fabricated. Short descriptor: "Compres burn garment jacket".
How much does Medicare pay for A6509?
In 2024, the average Medicare payment was $558.50 per service (average allowed $712.37).
Does Medicare cover A6509?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of A6509 can be billed per day?
2 on DME suppliers; 1 on outpatient hospital claims (NCCI medically unlikely edits).
Related A65 codes
- A6501 — Compression burn garment, bodysuit (head to foot), custom fabricated
- A6502 — Compression burn garment, chin strap, custom fabricated
- A6503 — Compression burn garment, facial hood, custom fabricated
- A6504 — Compression burn garment, glove to wrist, custom fabricated
- A6505 — Compression burn garment, glove to elbow, custom fabricated
- A6506 — Compression burn garment, glove to axilla, custom fabricated
- A6507 — Compression burn garment, foot to knee length, custom fabricated
- A6508 — Compression burn garment, foot to thigh length, custom fabricated
- A6510 — Compression burn garment, trunk, including arms down to leg openings (leotard), custom fabricated
- A6511 — Compression burn garment, lower trunk including leg openings (panty), custom fabricated
- A6512 — Compression burn garment, not otherwise classified
- A6513 — Compression burn mask, face and/or neck, plastic or equal, custom fabricated
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 A6509
- Watch A6509 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6509
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.