Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Xeroform Gauze 5X9
Low
$0
Average
$19
Median
$5
High
$73
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Reflects a payer-specific billing methodology not covered by the standard categories.
Showing only prices reported under the other methodology. Choose another in the filter above to change the chart. 25 hospitals; the 90th percentile is 5796.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Click a bar to filter the hospitals table to that price range.
| # | Hospital | ||||||
|---|---|---|---|---|---|---|---|
| 1 | Holy Redeemer Health System Meadowbrook, PA | $73 | $73 | — | — | 3–30 | $3 – $87 |
| 2 | Benefis Community Care, Inc Great Falls, MT | $0 | $0 | — | — | — | $0 – $0 |
| 3 | Henry Ford Health Detroit, MI | $3 | $3 | $0 | 6% | — | $3 – $3 |
| 4 | Henry Ford Health Southfield, MI | $3 | $3 | $0 | 8% | — | $3 – $3 |
| 5 | Henry Ford Health Novi, MI | $3 | $3 | $0 | 8% | — | $3 – $3 |
| 6 | Henry Ford Health Warren, MI | $3 | $3 | $0 | 5% | — | $3 – $3 |
| 7 | SwedishAmerican Hospital Rockford, IL | $4 | $4 | $0 | 4% | — | $1 – $1.1k |
| 8 | Childrens Hospital of Los Angeles Angeles, CA | $0 | $0 | $0 | 23% | — | $0 – $1 |
| 9 | Nationwide Children's Hospital Columbus, OH | $26 | $26 | — | — | — | $26 – $26 |
| 10 | Nationwide Children's Hospital Toledo, Llc Toledo, OH | $19 | $19 | $0 | 0% | — | $19 – $19 |
Ask Claude or any MCP client for HCPCS A6223 pricing at a specific hospital — see how to connect.