HCPCS Range Gauze Dressings

• 1 Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ( A6216 )

• 2 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 ( A6217 )

• 3 Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing ( A6218 )

• 4 Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing ( A6219 )

• 5 Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing ( A6220 )

• 6 Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing ( A6221 )

• 7 Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ( A6222 )

• 8 Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing ( A6223 )

• 9 Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ( A6224 )

• 10 Gauze, impregnated, water or normal saline, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing ( A6228 )

• 11 Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing ( A6229 )

• 12 Gauze, impregnated, water or normal saline, sterile, pad size more than 48 sq. in., without adhesive border, each dressing ( A6230 )

• 13 Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing ( A6231 )

• 14 Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing ( A6232 )

• 15 Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing ( A6233 )