Key facts for A6230
- Medicare payment
- no PFS amount
- PFS status P
- Coverage code
- D
- special coverage instructions apply
- Practitioner MUE
- 0
- MAI 3
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 1 / 0
TL;DR
A6230 is a Level II code from the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), in use since 1997: "Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing". The physician fee schedule lists A6230 with status P (bundled or excluded: no separate physician fee schedule payment), so the PFS carries no national amount for it. MUE limits for A6230: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 0 (MAI 3, Published Contractor Policy). 1 active LCD lists A6230: L33831 (Surgical Dressings). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1A (medical/surgical supplies); pricing indicator 46; type of service S (surgical dressings or other medical supplies). 18 other active codes open with "Gauze"; related codes: A6219, A6216, A6402, A6229.
A6230 descriptor and code status
The October 2026 HCPCS Level II file describes A6230 as “Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes.
| Field | Value |
|---|---|
| Short descriptor | Gauze > 48 sq in water/salne |
| Added to HCPCS | 1997-01-01 |
| Last action | N (no maintenance), effective 2009-01-01 |
| Coverage code | D: special coverage instructions apply |
| Pricing indicator | 46: DMEPOS contractor-priced (not otherwise classified, individual determination or gap-filled) |
| BETOS category | D1A: medical/surgical supplies |
| Type of service | S: surgical dressings or other medical supplies |
Medicare payment for A6230
The physician fee schedule lists A6230 with status P (bundled or excluded: no separate physician fee schedule payment), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.
Physician fee schedule (RVU26D)
Status P: bundled or excluded: no separate physician fee schedule payment. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).
Hospital outpatient (OPPS Addendum B)
Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.
Medically Unlikely Edits for A6230
MUE limits for A6230: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 0 (MAI 3, Published Contractor Policy). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 0 | 3 Date of Service Edit: Clinical | CMS Policy |
| Facility outpatient hospital | 1 | 3 Date of Service Edit: Clinical | Clinical: Data |
| DME supplier | 0 | 3 Date of Service Edit: Clinical | Published Contractor Policy |
The MUE lookup for A6230 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists A6230 in v323r0.
A6230 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.
Pair counts show exposure, not the answer for one claim. Check A6230 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for A6230
1 active Local Coverage Determination and 0 billing and coding articles list A6230. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.
- LCD L33831: Surgical Dressings · CGS Administrators, LLC; Noridian Healthcare Solutions, LLC
Denials to expect on A6230
the diagnosis or documentation does not meet the LCD or billing article that lists A6230
the modifier reported is inconsistent with the code
the claim lacks the description, invoice or pricing detail a contractor-priced code needs
Where QuickIntell fits for A6230 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A6230 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.
Frequently asked questions: HCPCS A6230
What does HCPCS code A6230 describe?
"Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing" (short descriptor "Gauze > 48 sq in water/salne"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 1997-01-01; last action N (no maintenance) effective 2009-01-01.
Is A6230 a CPT code?
No: CMS maintains A6230 in HCPCS Level II, while the AMA maintains CPT. It goes in the same procedure-code field.
What does Medicare pay for A6230?
The physician fee schedule lists A6230 with status P (bundled or excluded: no separate physician fee schedule payment), so the PFS carries no national amount for it.
How many units of A6230 can be billed per day?
MUE limits for A6230: practitioner 0 (MAI 3, CMS Policy); hospital outpatient 1 (MAI 3, Clinical: Data); DME supplier 0 (MAI 3, Published Contractor Policy). For the practitioner MUE (MAI 3), units above 0 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.
Does Medicare cover A6230?
Coverage code D (special coverage instructions apply). 1 active LCD lists A6230: L33831 (Surgical Dressings).
Sources
Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare PFS national relative value file RVU26D (non-QPP), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_nonQPP.csvSHA-256 4d0d3f19bd954ffc…
- Medicare PFS national relative value file RVU26D (qualifying APM participants), October 2026Version RVU26D, released 2026-08-26 · effective 2026-10-01 · file PPRRVU2026_Oct_QPP.csvSHA-256 59d3734704853936…
- OPPS Addendum B, October 2026Version October 2026 · effective 2026-10-01 · file 508-compliant-version-2026_October_Web_Addendum_B.09.28.26.csvSHA-256 6ad7393a318bf1b9…
- Integrated Outpatient Code Editor v27.3 data tables: status and payment indicatorsVersion I/OCE v27.3 (October 2026) · effective 2026-10-01 · file Data_Status_Indicator.txtSHA-256 78f119ef0a435351…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- Medicare Coverage Database, current LCD exportVersion MCD release 2026-10-08 · effective 2026-10-04 · file lcd.csvSHA-256 9aee1bd7f14056b0…
Disclaimer
This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.
Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.