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See a sample rate comparisonHCPCS A6259 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.
Transparent film, sterile, more than 48 sq. in., each dressing
| Key Fact | Detail |
|---|---|
| Service Type | Medical And Surgical Supplies Other Dressings, Coverings, and Wound Treatment Supplies |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for A6259 |
National average reimbursement for HCPCS A6259 by major payers:
$12.62
$8.14
$10.41
$18.15
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HCPCS A6259
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$27.94Published rateTy Cobb Healthcare System, Cobb Memorial Hospital
Community Services Group Inc
$8.61Published rateMamta Mahajan
Orthopedic Specialists Of Sw Florida
$7.26Published rateLower Oconee Community Hospital Inc
$7.11Published rateChristopher Raio
St Francis Hospital
$4.57Published rate
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See a sample payer proposalHCPCS A6259 vs. Other Other Dressings, Coverings, and Wound Treatment Supplies Codes
The HCPCS A6259 code is part of the Medical And Surgical Supplies services used for Other Dressings, Coverings, and Wound Treatment 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 A6259 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 |
|---|---|---|
| A6258-HCPCS | Low | Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
| A6259-HCPCS | Low | Transparent film, sterile, more than 48 sq. in., each dressing |
| A6260-HCPCS | Low | Wound cleansers, any type, any size |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS A6259. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the A6259 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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