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HCPCS A6231 · Level II · A code

A6231: Gauze, impregnated, hydrogel, for direct wound contact, sterile, HCPCS Level II A code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and DMEPOS fee schedule and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for A6231

Medicare payment
$6.66 to $6.68
DMEPOS non-rural state fees
Coverage code
D
special coverage instructions apply
Practitioner MUE
0
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

HCPCS Level II A6231 reads "Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing" in the October 2026 file; it dates from 2001. The October 2026 DMEPOS fee schedule (category SD, surgical dressings) sets A6231 at $6.66 in CT, DC, DE and 15 more to $6.68 in AL, AR, AZ and 28 more (floor $5.68, ceiling $6.68). CMS caps A6231 at practitioner 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. 1 active LCD lists A6231: L33831 (Surgical Dressings). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1A (medical/surgical supplies); pricing indicator 35; type of service S (surgical dressings or other medical supplies). 18 other active codes open with "Gauze"; related codes: A6219, A6216, A6402, A6230.

A6231 descriptor and code status

The October 2026 HCPCS Level II file describes A6231 as “Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing”. It sits in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational), listed with the other A codes.

HCPCS file attributes of A6231
FieldValue
Short descriptorHydrogel dsg<=16 sq in
Added to HCPCS2001-01-01
Last actionN (no maintenance), effective 2009-01-01
Coverage codeD: special coverage instructions apply
Pricing indicator35: DMEPOS surgical dressings (floors and ceilings)
BETOS categoryD1A: medical/surgical supplies
Type of serviceS: surgical dressings or other medical supplies

Medicare payment for A6231

The October 2026 DMEPOS fee schedule (category SD, surgical dressings) sets A6231 at $6.66 in CT, DC, DE and 15 more to $6.68 in AL, AR, AZ and 28 more (floor $5.68, ceiling $6.68). 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 X: statutory exclusion: not a physician service under the fee schedule. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

DMEPOS fee schedule (DME26-D)

Jurisdiction J (DME MAC or Part B MAC (joint)), payment category SD (surgical dressings). Fees are set per state; AK, HI, PR and VI are not subject to the national ceiling and floor and are listed separately. A rural fee applies only in ZIP codes on the CMS rural ZIP list.

DMEPOS fees for A6231 by modifier
ModifierFloor / ceilingNon-rural state rangeRural rangeAK / HI / PR / VI
none$5.68 / $6.68$6.66 (CT, DC, DE…) to $6.68 (AL, AR, AZ…)—AK $6.68, HI $6.68, PR $7.95, VI $6.68

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 A6231

CMS caps A6231 at practitioner 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for A6231 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy

The MUE lookup for A6231 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists A6231 in v323r0.

A6231 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 A6231 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for A6231

1 active Local Coverage Determination and 0 billing and coding articles list A6231. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on A6231

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists A6231

CARC 151 · N362

units of A6231 exceed the practitioner MUE of 0 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier

Where QuickIntell fits for A6231 claims

QuickAuth coordinates the requirement checks and documentation that DME claims for A6231 depend on, with human review of each case, and QuickRCM carries claim readiness and the CARC 50, 151 and modifier denials these items draw.

See QuickAuth for requirement checksSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS A6231

What does HCPCS code A6231 describe?

"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing" (short descriptor "Hydrogel dsg<=16 sq in"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2001-01-01; last action N (no maintenance) effective 2009-01-01.

Is A6231 a CPT code?

It is not. A6231 belongs to the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational) of HCPCS Level II, the CMS code set, not to AMA CPT.

What does Medicare pay for A6231?

The October 2026 DMEPOS fee schedule (category SD, surgical dressings) sets A6231 at $6.66 in CT, DC, DE and 15 more to $6.68 in AL, AR, AZ and 28 more (floor $5.68, ceiling $6.68).

How many units of A6231 can be billed per day?

CMS caps A6231 at practitioner 0 (MAI 3, CMS Policy) units per day in the 2026 Q4 MUE tables. 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 A6231?

Coverage code D (special coverage instructions apply). 1 active LCD lists A6231: 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.

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.