A6557 Thigh-Length Compression Stocking | HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS A6557: Thigh-Length Gradient Compression Stocking, 30-40 mmHg, Custom

HCPCS Level II code A6557 represents a custom, thigh-length gradient compression stocking delivering 30-40 mmHg of compression, billed per garment. These custom stockings are clinically important for managing chronic venous insufficiency, lymphedema, post-thrombotic syndrome, and other conditions where high-level graduated compression is indicated. Nationally, correct coding for custom compression garments affects durable medical equipment coverage decisions, prior authorization workflows, and patient cost-sharing.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service for this DME item, plus guidance on what to expect in payer coverage approaches. The publication summarizes common billing considerations, typical modifiers used in practice (input provided), and highlights where Data not available in the input.

This resource is designed for billing managers, durable medical equipment suppliers, and clinicians who document and bill for custom compression therapy. It focuses on clear definitions, billing nomenclature, and the operational implications of using HCPCS Level II code A6557 for custom thigh-length compression stockings at the 30-40 mmHg level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA6557HCPCS Level IIcompression stockingdurable medical equipmentthigh-length30-40 mmhgcustom garmentmedical billingDME billing

Billing Code Overview

HCPCS Level II code A6557 describes a gradient compression stocking, thigh length, 30-40 mmHg, custom, each. This item is a custom-fitted medical compression garment intended to provide graduated compression from the ankle upward to the thigh, with a compression rating of 30-40 mmHg.

Service Type: Custom durable medical equipment (compression garment)

Typical Site of Service: Outpatient durable medical equipment supplier, clinic fitting, or home delivery with custom fitting

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 68-year-old female with chronic venous insufficiency and recurrent left lower-extremity edema is seen in a vascular clinic. She reports aching, heaviness, and early-stage venous stasis changes despite compression wrap trial and conservative measures. The vascular clinician measures limb circumference and orders a custom, thigh-length gradient compression stocking, 30–40 mmHg, for the left leg to provide graduated compression from ankle to thigh and to address edema and venous reflux. The clinical workflow includes an outpatient evaluation by a vascular specialist or certified fitter, measurement and documentation of limb dimensions, ordering the custom device using billing code A6557, fitting session scheduled for delivery and instruction on donning/doffing, and follow-up visits to assess fit, skin condition, and symptom control. Typical site of service is an outpatient vascular clinic, durable medical equipment (DME) supplier location, or specialty clinic with certified compression garment fitting.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the stocking is custom-made for the left lower extremity.
`RT`

Related Codes

HCPCS-A4245-ALCOHOL-WIPES-PER-BOX

HCPCS Level II A4245: Alcohol Wipes, Per Box

HCPCS-A4565-SLINGS-SUPPORT-DEVICE

HCPCS A4565: Slings

HCPCS-A5501-CUSTOM-MOLDED-DIABETIC-SHOE

HCPCS A5501: Custom Molded Therapeutic Shoe for Diabetes

HCPCS-A6545-GRADIENT-COMPRESSION-WRAP-BELOW-KNEE

HCPCS A6545: Below-Knee Gradient Compression Wrap, Non-Elastic

HCPCS-A6524-GRADIENT-COMPRESSION-GARMENT-LOWER-LEG-FOOT-NIGHTTIME

HCPCS A6524: Gradient Compression Garment, Lower Leg and Foot, Nighttime

HCPCS-A4379-URINARY-OSTOMY-POUCH-PLASTIC-FACEPLATE-ATTACHED

HCPCS A4379: Urinary Ostomy Pouch with Faceplate, Plastic

HCPCS-A4330-PERIANAL-FECAL-COLLECTION-POUCH-ADHESIVE

HCPCS Level II A4330: Perianal Fecal Collection Pouch with Adhesive

HCPCS-A4270-DISPOSABLE-ENDOSCOPE-SHEATH

HCPCS A4270: Disposable Endoscope Sheath, Each

HCPCS-A6605-GRADIENT-COMPRESSION-FOAM-BANDAGING-SUPPLY-PER-YARD

HCPCS Level II A6605: Gradient Compression Padded Foam Bandaging, per Linear Yard

HCPCS-A6503-COMPRESSION-BURN-GARMENT-FACIAL-HOOD-CUSTOM

HCPCS Level II A6503: Compression Burn Garment, Facial Hood, Custom Fabricated

Showing 1–10 of 633

Taxonomy Code	Specialty	Notes
`2084P0801X`	Vascular Medicine	Common prescribers for compression therapy and DME orders.
`2080S0102X`	General Surgery (Vascular Surgery)	Specialists who evaluate venous disease and order custom stockings.
`261QM0800X`	Rehabilitation Services, Prosthetics & Orthotics	Certified fitters and DME suppliers who measure and fabricate custom compression garments.
`207L00000X`	Cardiology	Cardiologists managing chronic venous insufficiency in some practices and prescribing compression therapy.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I83.013`	Varicose veins of left lower extremity with ulcer of thigh	Varicose disease with ulceration may require 30–40 mmHg compression to reduce venous hypertension and assist healing.
`I83.111`	Varicose veins of right lower extremity with pain	Symptomatic varicose veins causing pain are an indication for graduated compression to relieve symptoms.
`I87.2`	Venous insufficiency (chronic) (peripheral)	Chronic venous insufficiency is a primary indication for custom compression stockings to manage edema and stasis changes.
`I89.0`	Lymphedema, not elsewhere classified	Moderate to severe lymphedema often requires custom, higher-gradient compression stockings for limb volume management.
`L97.423`	Non-pressure chronic ulcer of left lower leg with partial thickness skin loss	Chronic venous ulcers benefit from compression therapy as part of wound management when arterial disease is excluded.
`R60.0`	Localized edema	Edema of a limb due to venous or lymphatic causes can be managed with graded compression garments.
`Z46.6`	Fitting and adjustment of other specified devices	Administrative code sometimes used to document fitting/adjustment encounters for custom compression garments.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29580`	Application of custom fabricated elastic stocking, thigh, each leg	A procedural code for custom-fabricated elastic stockings; use when billed as a professional service for application/fitting alongside supply of `A6557`.
`99070`	Supplies and materials (except spectacles), noncovered items or services billed separately by the physician	May be used by some practices to bill incidental supplies or fitting materials when payer rules allow alongside DME supplier billing.
`97535`	Self-care/home management training (e.g., activities of daily living, safety procedures), each 15 minutes	Used when documented patient education on donning/doffing and skin care is provided in therapy sessions concurrent with fitting.
`97110`	Therapeutic exercises to develop strength and endurance	Occasionally used in rehabilitation encounters addressing mobility and swelling management in conjunction with compression therapy.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	Common E/M visit code for the clinician evaluation that results in ordering a custom thigh-length stocking.
`99080`	Handling charges and administrative services (e.g., medical records)	Sometimes billed for administrative tasks associated with custom DME ordering depending on payer policies.