2025 HCPCS Code A6217

Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing

TAGS: adhesive dressing equal

Short Description	Non-sterile gauze>16<=48 sq
HCPCS Action Code	N - No maintenance for this code
HCPCS Coverage Code	D - Special coverage instructions apply
HCPCS Code Added Date	January 01, 1997
HCPCS Action Effective Date	January 01, 2003
HCPCS Pricing Indicator Code	35 - Surgical dressings (price subject to floors and ceilings)
HCPCS Type Of Service Code	S - Surgical dressings or other medical supplies (eff 04/95)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Coverage Issues Manual Reference Section Number