Surgical Dressings - 2006 Region A DMERC Fee Schedule Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage. HCPCS MOD1 MOD2 Ceiling Floor CT DE MA ME NH NJ NY PA RI VT --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- A4462 3.29 2.80 3.29 3.29 3.29 3.29 3.29 3.29 3.29 3.29 3.29 3.29 A6010 30.96 26.32 30.96 30.96 30.96 30.96 30.96 30.96 30.96 30.96 30.96 30.96 A6011 2.28 1.94 2.28 2.28 2.28 2.28 2.28 2.28 2.28 2.28 2.28 2.28 A6021 21.02 17.87 21.02 21.02 21.02 21.02 21.02 21.02 21.02 21.02 21.02 21.02 A6022 21.02 17.87 21.02 21.02 21.02 21.02 21.02 21.02 21.02 21.02 21.02 21.02 A6023 190.30 161.76 190.30 190.30 190.30 190.30 190.30 190.30 190.30 190.30 190.30 190.30 A6024 6.19 5.26 6.19 6.19 6.19 6.19 6.19 6.19 6.19 6.19 6.19 6.19 A6154 14.38 12.22 14.38 14.38 14.38 14.38 14.38 14.38 14.38 14.38 14.38 14.38 A6196 7.35 6.25 7.35 7.35 7.35 7.35 7.35 7.35 7.35 7.35 7.35 7.35 A6197 16.44 13.97 16.44 16.44 16.44 16.44 16.44 16.44 16.44 16.44 16.44 16.44 A6199 5.29 4.50 5.29 5.29 5.29 5.29 5.29 5.29 5.29 5.29 5.29 5.29 A6200 9.50 8.08 9.50 9.50 9.50 9.50 9.50 9.50 9.50 9.50 9.50 9.50 A6201 20.80 17.68 20.80 20.80 20.80 20.80 20.80 20.80 20.80 20.80 20.80 20.80 A6202 34.88 29.65 34.88 34.88 34.88 34.88 34.88 34.88 34.88 34.88 34.88 34.88 A6203 3.35 2.85 3.35 3.35 3.35 3.35 3.35 3.35 3.35 3.35 3.35 3.35 A6204 6.23 5.30 6.23 6.23 6.23 6.23 6.23 6.23 6.23 6.23 6.23 6.23 A6207 7.34 6.24 7.34 7.34 7.34 7.34 7.34 7.34 7.34 7.34 7.34 7.34 A6209 7.48 6.36 7.48 7.48 7.48 7.48 7.48 7.48 7.48 7.48 7.48 7.48 A6210 19.92 16.93 19.92 19.92 19.92 19.92 19.92 19.92 19.92 19.92 19.92 19.92 A6211 29.37 24.96 29.37 29.37 29.37 29.37 29.37 29.37 29.37 29.37 29.37 29.37 A6212 9.70 8.25 9.70 9.70 9.70 9.70 9.70 9.70 9.70 9.70 9.70 9.70 A6214 10.29 8.75 10.29 10.29 10.29 10.29 10.29 10.29 10.29 10.29 10.29 10.29 A6216 0.05 0.04 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 0.05 A6217 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6219 0.95 0.81 0.95 0.95 0.95 0.95 0.95 0.95 0.95 0.95 0.95 0.95 A6220 2.58 2.19 2.58 2.58 2.58 2.58 2.58 2.58 2.58 2.58 2.58 2.58 A6222 2.13 1.81 2.13 2.13 2.13 2.13 2.13 2.13 2.13 2.13 2.13 2.13 A6223 2.42 2.06 2.42 2.42 2.42 2.42 2.42 2.42 2.42 2.42 2.42 2.42 A6224 3.61 3.07 3.61 3.61 3.61 3.61 3.61 3.61 3.61 3.61 3.61 3.61 A6229 3.61 3.07 3.61 3.61 3.61 3.61 3.61 3.61 3.61 3.61 3.61 3.61 A6231 4.68 3.98 4.66 4.66 4.66 4.66 4.66 4.66 4.66 4.66 4.66 4.66 A6232 6.88 5.85 6.88 6.88 6.88 6.88 6.88 6.88 6.88 6.88 6.88 6.88 A6233 19.19 16.31 19.19 19.19 19.19 19.19 19.19 19.19 19.19 19.19 19.19 19.19 A6234 6.54 5.56 6.54 6.54 6.54 6.54 6.54 6.54 6.54 6.54 6.54 6.54 A6235 16.82 14.30 16.82 16.82 16.82 16.82 16.82 16.82 16.82 16.82 16.82 16.82 A6236 27.25 23.16 27.25 27.25 27.25 27.25 27.25 27.25 27.25 27.25 27.25 27.25 A6237 7.91 6.72 7.91 7.91 7.91 7.91 7.91 7.91 7.91 7.91 7.91 7.91 A6238 22.79 19.37 22.79 22.79 22.79 22.79 22.79 22.79 22.79 22.79 22.79 22.79 A6240 12.24 10.40 12.24 12.24 12.24 12.24 12.24 12.24 12.24 12.24 12.24 12.24 A6241 2.57 2.18 2.57 2.57 2.57 2.57 2.57 2.57 2.57 2.57 2.57 2.57 A6242 6.07 5.16 6.07 6.07 6.07 6.07 6.07 6.07 6.07 6.07 6.07 6.07 A6243 12.31 10.46 12.31 12.31 12.31 12.31 12.31 12.31 12.31 12.31 12.31 12.31 A6244 39.28 33.39 39.28 39.28 39.28 39.28 39.28 39.28 39.28 39.28 39.28 39.28 A6245 7.27 6.18 7.27 7.27 7.27 7.27 7.27 7.27 7.27 7.27 7.27 7.27 A6246 9.92 8.43 9.92 9.92 9.92 9.92 9.92 9.92 9.92 9.92 9.92 9.92 A6247 23.78 20.21 23.78 23.78 23.78 23.78 23.78 23.78 23.78 23.78 23.78 23.78 A6248 16.24 13.80 16.24 16.24 16.24 16.24 16.24 16.24 16.24 16.24 16.24 16.24 A6251 1.99 1.69 1.99 1.99 1.99 1.99 1.99 1.99 1.99 1.99 1.99 1.99 A6252 3.25 2.76 3.25 3.25 3.25 3.25 3.25 3.25 3.25 3.25 3.25 3.25 A6253 6.34 5.39 6.34 6.34 6.34 6.34 6.34 6.34 6.34 6.34 6.34 6.34 A6254 1.21 1.03 1.21 1.21 1.21 1.21 1.21 1.21 1.21 1.21 1.21 1.21 A6255 3.03 2.58 3.03 3.03 3.03 3.03 3.03 3.03 3.03 3.03 3.03 3.03 A6257 1.53 1.30 1.53 1.53 1.53 1.53 1.53 1.53 1.53 1.53 1.53 1.53 A6258 4.30 3.66 4.30 4.30 4.30 4.30 4.30 4.30 4.30 4.30 4.30 4.30 A6259 10.94 9.30 10.94 10.94 10.94 10.94 10.94 10.94 10.94 10.94 10.94 10.94 A6266 1.92 1.63 1.92 1.92 1.92 1.92 1.92 1.92 1.92 1.92 1.92 1.92 A6402 0.12 0.10 0.12 0.12 0.12 0.12 0.12 0.12 0.12 0.12 0.12 0.12 A6403 0.43 0.37 0.43 0.43 0.43 0.43 0.43 0.43 0.43 0.43 0.43 0.43 A6407 1.88 1.60 1.88 1.88 1.88 1.88 1.88 1.88 1.88 1.88 1.88 1.88 A6410 0.39 0.33 0.39 0.39 0.39 0.39 0.39 0.39 0.39 0.39 0.39 0.39 A6411 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6441 0.67 0.57 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 A6442 0.17 0.14 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 0.17 A6443 0.29 0.25 0.29 0.29 0.29 0.29 0.29 0.29 0.29 0.29 0.29 0.29 A6444 0.56 0.48 0.56 0.56 0.56 0.56 0.56 0.56 0.56 0.56 0.56 0.56 A6445 0.32 0.27 0.32 0.32 0.32 0.32 0.32 0.32 0.32 0.32 0.32 0.32 A6446 0.41 0.35 0.41 0.41 0.41 0.41 0.41 0.41 0.41 0.41 0.41 0.41 A6447 0.67 0.57 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 0.67 A6448 1.16 0.99 1.16 1.16 1.16 1.16 1.16 1.16 1.16 1.16 1.16 1.16 A6449 1.75 1.49 1.75 1.75 1.75 1.75 1.75 1.75 1.75 1.75 1.75 1.75 A6450 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6451 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6452 5.91 5.02 5.91 5.91 5.91 5.91 5.91 5.91 5.91 5.91 5.91 5.91 A6453 0.61 0.52 0.61 0.61 0.61 0.61 0.61 0.61 0.61 0.61 0.61 0.61 A6454 0.77 0.65 0.77 0.77 0.77 0.77 0.77 0.77 0.77 0.77 0.77 0.77 A6455 1.39 1.18 1.39 1.39 1.39 1.39 1.39 1.39 1.39 1.39 1.39 1.39 A6456 1.28 1.09 1.28 1.28 1.28 1.28 1.28 1.28 1.28 1.28 1.28 1.28 A6457 1.14 0.97 1.14 1.14 1.14 1.14 1.14 1.14 1.14 1.14 1.14 1.14 A6501 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6502 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6503 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6504 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6505 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6506 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6507 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6508 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6509 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6510 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6511 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6513 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 A6531 AW 43.27 36.78 43.27 43.27 43.27 43.27 43.27 43.27 43.27 43.27 43.27 43.27 A6532 AW 60.96 51.82 60.96 60.96 60.96 60.96 60.96 60.96 60.96 60.96 60.96 60.96