A6403 Sterile gauze>16 <= 48 sq in

Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing

• Medicare coverage: Special coverage instructions apply
• Status: active (July 2026 file)
• MUE: max 0 units per day (practitioner), rationale: CMS Policy