A6573 HCPCS code: Gradient compression garment, toe caps, custom, each
A6573 is the HCPCS Level II code for gradient compression garment, toe caps, custom, each. The 2026 Medicare DMEPOS fee schedule pays $249.43 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 6 per day on DME suppliers. In 2024, 148 suppliers billed Medicare for A6573 (purchases), serving 571 beneficiaries; Texas, Pennsylvania, New York accounted for 29% of services. Its average fee ranks 39 of 63 A65 codes (family range $0.18–$1,274.45).
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 40 — DMEPOS: lymphedema compression treatment item |
| BETOS category | O1L |
| Added | 2024-01-01 |
| Last action effective | 2024-01-01 |
2026 Medicare DMEPOS fee schedule for A6573
| Modifier | Meaning | Lowest state fee | Highest state fee | Ceiling | Floor |
|---|---|---|---|---|---|
| — | base fee | $249.43 | $249.43 | — | — |
| State | Modifier | Fee | Rural fee |
|---|---|---|---|
| AK | — | $249.43 | — |
| AL | — | $249.43 | — |
| AR | — | $249.43 | — |
| AZ | — | $249.43 | — |
| CA | — | $249.43 | — |
| CO | — | $249.43 | — |
| CT | — | $249.43 | — |
| DC | — | $249.43 | — |
| DE | — | $249.43 | — |
| FL | — | $249.43 | — |
| GA | — | $249.43 | — |
| HI | — | $249.43 | — |
| IA | — | $249.43 | — |
| ID | — | $249.43 | — |
| IL | — | $249.43 | — |
| IN | — | $249.43 | — |
| KS | — | $249.43 | — |
| KY | — | $249.43 | — |
| LA | — | $249.43 | — |
| MA | — | $249.43 | — |
| MD | — | $249.43 | — |
| ME | — | $249.43 | — |
| MI | — | $249.43 | — |
| MN | — | $249.43 | — |
| MO | — | $249.43 | — |
| MS | — | $249.43 | — |
| MT | — | $249.43 | — |
| NC | — | $249.43 | — |
| ND | — | $249.43 | — |
| NE | — | $249.43 | — |
| NH | — | $249.43 | — |
| NJ | — | $249.43 | — |
| NM | — | $249.43 | — |
| NV | — | $249.43 | — |
| NY | — | $249.43 | — |
| OH | — | $249.43 | — |
| OK | — | $249.43 | — |
| OR | — | $249.43 | — |
| PA | — | $249.43 | — |
| PR | — | $249.43 | — |
| RI | — | $249.43 | — |
| SC | — | $249.43 | — |
| SD | — | $249.43 | — |
| TN | — | $249.43 | — |
| TX | — | $249.43 | — |
| UT | — | $249.43 | — |
| VA | — | $249.43 | — |
| VI | — | $249.43 | — |
| VT | — | $249.43 | — |
| WA | — | $249.43 | — |
| WI | — | $249.43 | — |
| WV | — | $249.43 | — |
| WY | — | $249.43 | — |
How the A6573 fee compares
| Measure | Value |
|---|---|
| Rank among 63 A65 codes (lowest = 1) | 39 |
| Family fee range (average of state fees) | $0.18–$1,274.45 |
| Rural fee uplift | — |
Who bills A6573 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 148 |
| Referring clinicians | 532 |
| Medicare beneficiaries | 571 |
| States with claims | 23 |
| Share of services in top 3 states (Texas, Pennsylvania, New York) | 29% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for A6573, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 1,852 | 571 | $234.10 | $182.74 |
States with the most A6573 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 183 | $182.18 |
| Pennsylvania | 166 | $180.30 |
| New York | 132 | $183.93 |
| Minnesota | 122 | $182.03 |
| California | 118 | $182.12 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 6 | CMS Policy |
What changed for A6573
- 2026-01-01: Average state fee rose 2.7%: $242.87 to $249.43
- 2024-01-01: A6573 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 A6573?
A6573 is the HCPCS Level II code for gradient compression garment, toe caps, custom, each. Short descriptor: "Grad com garmnt toe cap cust".
How much does Medicare pay for A6573?
Under the 2026 DMEPOS fee schedule, non-rural state fees are base (base fee): $249.43. Rural fees can be higher.
Does Medicare cover A6573?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Did the Medicare fee for A6573 change in 2026?
The average non-rural state fee moved from $242.87 in 2025 to $249.43 in 2026 (+2.7%). CMS's next quarterly HCPCS and DMEPOS update takes effect January 1, 2027.
How many units of A6573 can be billed per day?
6 on DME suppliers (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
- A6509 — Compression burn garment, upper trunk to waist including arm openings (vest), 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
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 A6573
- Watch A6573 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A6573
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.