Key facts for A6611
- Medicare payment
- no PFS amount
- PFS status X; OPPS SI A: paid under another fee schedule or system
- Coverage code
- C
- carrier judgment, so the Medicare contractor decides coverage
- DME supplier MUE
- 6
- MAI 2
- NCCI PTP pairs
- 0
- practitioner file
- LCDs and articles
- 0 / 0
TL;DR
CMS describes HCPCS A6611, added in 2025, as "Gradient compression wrap with adjustable straps, above knee, each, custom". The physician fee schedule lists A6611 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays A6611 under a fee schedule or payment system other than OPPS. Its 2026 Q4 MUEs per date of service: DME supplier 6 (MAI 2, CMS Policy). A6611 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD. HCPCS record: BETOS O1L (lymphedema compression treatment items); pricing indicator 40; type of service S (surgical dressings or other medical supplies). 10 other active codes open with "Gradient compression wrap with adjustable straps"; related codes: A6588, A6587, A6586, A6585.
A6611 descriptor and code status
The October 2026 HCPCS Level II file describes A6611 as “Gradient compression wrap with adjustable straps, above knee, each, custom”. 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 | Grad com wrap w strap ak cus |
| Added to HCPCS | 2025-04-01 |
| Last action | N (no maintenance), effective 2025-04-01 |
| Coverage code | C: carrier judgment, so the Medicare contractor decides coverage |
| Pricing indicator | 40: DMEPOS lymphedema compression treatment items |
| BETOS category | O1L: lymphedema compression treatment items |
| Type of service | S: surgical dressings or other medical supplies |
Medicare payment for A6611
The physician fee schedule lists A6611 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays A6611 under a fee schedule or payment system other than OPPS. 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).
Hospital outpatient (OPPS Addendum B)
Status indicator A (Services not paid under OPPS; paid under fee schedule or other payment system), with no separate OPPS payment rate.
Medically Unlikely Edits for A6611
Its 2026 Q4 MUEs per date of service: DME supplier 6 (MAI 2, CMS Policy). The DME supplier MUE is a date-of-service policy edit: units above the limit deny even when split across lines, and appeals rarely succeed.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| DME supplier | 6 | 2 Date of Service Edit: Policy | CMS Policy |
The MUE lookup for A6611 shows every setting next to any other code on the same claim.
NCCI edits and add-on rules
No active practitioner PTP pair lists A6611 in v323r0.
A6611 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 A6611 against a second code to see whether the pair bundles and whether a modifier can separate the services.
Medicare coverage policies for A6611
No current LCD or billing and coding article lists A6611. The HCPCS coverage code C means carrier judgment, so the Medicare contractor decides coverage, and any National Coverage Determination for the service still applies.
Denials to expect on A6611
the modifier reported is inconsistent with the code
the claim lacks information needed to adjudicate the line, such as an order, NPI or required modifier
Where QuickIntell fits for A6611 claims
QuickCode supports qualified coder review of units, modifiers and NCCI pairs for A6611 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 A6611
What does HCPCS code A6611 describe?
"Gradient compression wrap with adjustable straps, above knee, each, custom" (short descriptor "Grad com wrap w strap ak cus"), in the A section (transportation, medical and surgical supplies, administrative, miscellaneous and investigational). Added 2025-04-01.
Is A6611 a CPT code?
No. A6611 is a CMS HCPCS Level II code; CPT codes are the AMA's five-character set.
What does Medicare pay for A6611?
The physician fee schedule lists A6611 with status X (statutory exclusion: not a physician service under the fee schedule), so the PFS carries no national amount for it. Its OPPS status indicator is A, which the I/OCE table defines as "Services not paid under OPPS; paid under fee schedule or other payment system": Medicare pays A6611 under a fee schedule or payment system other than OPPS.
How many units of A6611 can be billed per day?
Its 2026 Q4 MUEs per date of service: DME supplier 6 (MAI 2, CMS Policy). For the DME supplier MUE (MAI 2), units above 6 deny for the whole day as a policy limit; denials arrive as CARC 151.
Does Medicare cover A6611?
A6611 appears in no active LCD or billing and coding article, so coverage follows HCPCS coverage code C (carrier judgment, so the Medicare contractor decides coverage) and any NCD.
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…
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.