Adhesive Border Wound Cover, ≤16 sq in
Gauze, non-impregnated, non-elastic, with adhesive border, sterile, pad size 16 sq. in. or less, each dressing
Reference only. The rate shown is the Medicare reimbursement amount published by CMS — not Total Surgical pricing. It reflects the published 2026 CMS DMEPOS fee schedule. Final reimbursement is subject to medical necessity, complete documentation, payer coverage, supplier accreditation, and applicable LCD guidance. Not a guarantee of payment.
| Product | Size |
|---|---|
| Adhesive Island Dressing | 2" × 2.8" |
| Adhesive Island Dressing | 3.2" × 4" |
| Adhesive Island Dressing | 3.2" × 6" |
| Adhesive Island Dressing | 4" × 4" |
| Adhesive Island Dressing | 4" × 6" |
| Adhesive Island Dressing | 4" × 8" |
| Adhesive Island Dressing | 4" × 10" |
Code assignment based on PDAC verification at time of publication. Codes subject to change per CMS policy.
Used as an outer protective layer with a built-in adhesive border. Holds the central absorbent pad in place and provides a water-resistant barrier against outside contaminants.
Documentation requirements include — but are not limited to — wound identification, measurement standards, vascular status, nutritional assessment, complicating factors, evidence of improvement, treatment goals, a Standard Written Order (SWO), and proof of delivery. Refer to the most current CMS LCD for surgical dressings.
In the WoundKit Partner Portal, the right HCPCS code, documentation, and proof of delivery come together in a single billing-ready packet. A 20-minute demo walks through a live order.
