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See a sample rate comparisonHCPCS A6197 Fee Schedule
HCPCS A6197 is classified under Medical And Surgical Supplies, in the Miscellaneous Dressing and Wound Supplies subgroup.
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Miscellaneous Dressing and Wound Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | $19.955 median of the 8 states in the free preview · View Medicaid rates for A6197 |
National average reimbursement for HCPCS A6197 by major payers:
$18.64
BCBS / Anthem
$12.22
UnitedHealthcare
$15.57
Aetna
$27.24
Cigna
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HCPCS A6197
5 of 25 sample ratesHigher to lower in this preview
Summit Ridge Medical Center
$16.82Published rateCara Fanning
Infectious Diseases Of Nevada LLC
$12.32Published rateSarah Zalaznik
$9.73Published rateEye Associates Of Nevada, Wellish Vision Institute
Eye Associates Of Nevada Wellish, P.C.
$9.73Published rateHima Illindala
$4.65Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A6197 vs. Other Miscellaneous Dressing and Wound Supplies Codes
The table lists codes related to A6197. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A6196-HCPCS | Low | Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
| A6197-HCPCS | Low | Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
| A6198-HCPCS | Low | Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A6197. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6197 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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