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See a sample rate comparisonHCPCS A6204 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Miscellaneous Dressing and Wound Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A6204 |
National average reimbursement for HCPCS A6204 by major payers:
$7.11
$4.64
$5.92
$10.26
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HCPCS A6204
5 of 25 sample ratesHigher to lower in this preview
Adib Abla
$35.70Published rateEvelyn Cavalier
Nyc Podiatric Medicine And Surgery PC
$4.34Published rateGabriel Gonzales-Portillo
Baycare Medical Group Inc
$4.15Published rateFoot & Ankle Specialists Of Jacksonville, Inc.
Foot Ankle Specialists Of Jacksonville Inc
$4.01Published rateJames Shaw
Specialty Associates Of West Houston PLLC
$2.46Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A6204 vs. Other Miscellaneous Dressing and Wound Supplies Codes
The HCPCS A6204 code is part of the Medical And Surgical Supplies services used for Miscellaneous Dressing and Wound Supplies. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS A6204 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| A6203-HCPCS | Low | Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
| A6204-HCPCS | Low | Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
| A6205-HCPCS | Low | Composite dressing, sterile, pad size more than 48 sq. in., with any size adhesive border, 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 A6204. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6204 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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