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See a sample rate comparisonHCPCS A6243 Fee Schedule
HCPCS A6243 is classified under Medical And Surgical Supplies, in the Hydrogel Dressings subgroup.
Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Hydrogel Dressings |
| Complexity Level | Low |
| Medicaid Fee Schedule | $14.945 median of the 8 states in the free preview · View Medicaid rates for A6243 |
National average reimbursement for HCPCS A6243 by major payers:
$14.44
BCBS / Anthem
$9.17
UnitedHealthcare
$12.07
Aetna
$20.17
Cigna
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HCPCS A6243
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$31.50Published ratePiedmont Newton Ekg Billing LLC
Piedmont Newton Hospital Inc
$19.43Published rateNevada Eye Care Professionals Little & Stein, Ltd.
Nevada Eye Care Professionals
$9.23Published rateJasper Health Services, Inc., Jasper Memorial Hospital
Jasper Health Services Inc
$8.00Published rateBorbas Surgical Supply, Inc
Borbas Surgical Supply Inc
$5.50Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS A6243 vs. Other Hydrogel Dressings Codes
The table lists codes related to A6243. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| A6242-HCPCS | Low | Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
| A6243-HCPCS | Low | Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
| A6244-HCPCS | Low | Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without 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 A6243. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6243 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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