MyMedi-AI

A6540 — Gradient compression stocking, waist length, 30-40 mmhg, each

HCPCS Level II A-code · short descriptor: “Gc stocking waistlngth 30-40”

Code system
HCPCS Level II
Family
A — Medical & surgical supplies, ambulance
Medicare coverage status
Carrier judgment — coverage decided by the DME MAC
DMEPOS payment category
LC
Prior authorization
Not on Medicare required-PA list
Face-to-face & WOPD
Not on the required list
MUE unit limit
6
Status
Active (HCPCS Level II October 2026)

Prior authorization

Not on the Medicare required-PA list (CMS Required Prior Authorization List — 74 items in force on 2026-10-25; 8 more from 2026-10-28; sources: CMS list updated 2026-01-13, CMS-6109-N (91 FR 47972)). Medicare Advantage and commercial plans set their own prior-authorization rules for this code — verify per plan before delivery.

Order readiness — what the written order must contain

Every Medicare DMEPOS claim needs a Standard Written Order with all six elements (42 CFR 410.38(d)):

  • Beneficiary name or Medicare Beneficiary Identifier (MBI) (42 CFR 410.38(d)(1)(i)(A))
  • General description of the item (42 CFR 410.38(d)(1)(i)(B))
  • Quantity to be dispensed, if applicable (42 CFR 410.38(d)(1)(i)(C))
  • Order date (42 CFR 410.38(d)(1)(i)(D))
  • Treating practitioner name or NPI (42 CFR 410.38(d)(1)(i)(E))
  • Treating practitioner signature (42 CFR 410.38(d)(1)(i)(F))

Not on the F2F/WOPD list (CMS Required F2F & WOPD List — 83 items in force on 2026-10-25; 22 more from 2026-10-28; sources: CMS list effective 2026-04-13 (91 FR 1250), CMS-6109-N (91 FR 47972)). The standard written order must reach the supplier before claim submission.

Blank requirements checklist only — MyMedi-AI never collects or stores completed orders.

A6540 Medicare fee schedule (October 2026)

Base (no modifier) LC

Medicare allowable: $116.68 in all listed states.

StateNon-ruralRural
AK$116.68—
AL$116.68—
AR$116.68—
AZ$116.68—
CA$116.68—
CO$116.68—
CT$116.68—
DC$116.68—
DE$116.68—
FL$116.68—
GA$116.68—
HI$116.68—
IA$116.68—
ID$116.68—
IL$116.68—
IN$116.68—
KS$116.68—
KY$116.68—
LA$116.68—
MA$116.68—
MD$116.68—
ME$116.68—
MI$116.68—
MN$116.68—
MO$116.68—
MS$116.68—
MT$116.68—
NC$116.68—
ND$116.68—
NE$116.68—
NH$116.68—
NJ$116.68—
NM$116.68—
NV$116.68—
NY$116.68—
OH$116.68—
OK$116.68—
OR$116.68—
PA$116.68—
PR$116.68—
RI$116.68—
SC$116.68—
SD$116.68—
TN$116.68—
TX$116.68—
UT$116.68—
VA$116.68—
VI$116.68—
VT$116.68—
WA$116.68—
WI$116.68—
WV$116.68—
WY$116.68—
Amounts are the Medicare DMEPOS fee-schedule allowables effective October 2026 (CMS DMEPOS Fee Schedule October 2026 (DME26-D)). Medicare typically pays 80% of the allowable after the Part B deductible; the patient owes 20%. A 2% sequestration reduction applies to the Medicare share. Former competitive-bidding-area adjustments and non-continental rates can differ — verify with your DME MAC.

Unit limit (MUE)

Medicare's Medically Unlikely Edit caps A6540 at 6 units per date of service (absolute). Units above the MUE deny — typically as CO-151. Rationale: CMS Policy.

Common denial codes to watch

Related A-codes

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