HCPCS A6218 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medical And Surgical Supplies • Gauze Dressings |
| Complexity Level | Low |
National average reimbursement for HCPCS A6218 by major payers:
$0.69
$0.26
$0.27
$0.52
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS A6218 | ||||||
United | A6218 | $0.21 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | A6218 | $0.21 | 1679845531 - DANA HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | A6218 | $0.40 | 1992789721 - PHOEBE PUTNEY MEMORIAL HOSPITAL INC, PHOEBE PUTNEY MEMORIAL HOSPTIAL | 581928247 - (GA) PHOEBE PUTNEY MEMORIAL HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A6218 | $0.18 | 1659376630 - UPSON COUNTY HOSPITAL INC, UPSON REGIONAL MEDICAL CENTER | 581734026 - (GA) UPSON COUNTY HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | A6218 | $0.33 | 1033435664 - SMITH OF GEORGIA, SMITH NORTHVIEW HOSPITALISTS | 271652335 - (GA) SMITH OF GEORGIA | GA | General Acute Care Hospital (282N00000X) |
United | A6218 | $0.21 | 1417157405 - EMORY HEALTHCARE | 901116753 | GA | General Acute Care Hospital (282N00000X) |
United | A6218 | $0.36 | 1063741163 - AZTEC URGENT CARE, LLC | 271495988 - (NM) AZTEC URGENT CARE LLC | NM | Urgent Care Clinic/Center (261QU0200X) |
United | A6218 | $0.21 | 1063490845 - KEVIN SCHLESSEL | 311425166 | OH | Rheumatology Physician (207RR0500X) |
United | A6218 | $0.20 | 1669488250 - ELBERT MEMORIAL HOSPITAL | 586002491 - (GA) ELBERT MEMORIAL HOSPITAL | GA | Critical Access Hospital (282NC0060X) |
United | A6218 | $0.20 | 1184771586 - LOWER OCONEE COMMUNITY HOSPITAL INC | 208897263 | GA | Critical Access Hospital (282NC0060X) |
United | A6218 | $0.18 | 1134259328 - BORBAS SURGICAL SUPPLY, INC | 113568895 - (NY) BORBAS SURGICAL SUPPLY INC | NY | Durable Medical Equipment & Medical Supplies (332B00000X) |
United | A6218 | $0.27 | 1497064679 - JENKINS COUNTY HOSPITAL LLC, OPTIM MEDICAL CENTER - JENKINS | 581158547 - (GA) HOSPITAL AUTHORITY OF JENKINS COUNTY DBA JENKINS COUNTY MEDICAL CENTER | GA | Critical Access Hospital (282NC0060X) |
United | A6218 | $0.27 | 1760452098 - HOSPITAL AUTHORITY OF JENKINS COUNTY | 273100894 | GA | Critical Access Hospital (282NC0060X) |
United | A6218 | $0.95 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | A6218 | $0.50 | 1760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS A6218 vs. Other Gauze Dressings Codes
The HCPCS A6218 code is part of the Medical And Surgical Supplies services used for Gauze Dressings. 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 A6218 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 |
|---|---|---|
| A6217-HCPCS | Low | 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 |
| A6218-HCPCS | Low | Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
| A6219-HCPCS | Low | Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, 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 A6218. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6218 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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