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XTRASORB® Classic Super Absorbent Dressing, 4" x 5" Non-Adhesive, Pack of 100

XTRASORB® Classic Super Absorbent Dressing is a wound dressing. INTENDED USES: May be used for: pressure, venous, arterial and neuropathic ulcers, post-operative and traumatic wounds and donor sites. CLAIMED FEATURES: It is a novel super-absorbent wound dressing. At its core is a super-absorbent polymer that allows the dressing to absorb significantly increased amounts of fluid as compared to that of typical highly absorbent dressings. Whereas other absorbent dressings (including foams, ABD pads, and other cellulose based dressings) rely on spaces or cavities within the dressings to fill with fluid, XTRASORB's super absorbent polymer converts fluid within the dressing into a gel. This keeps the fluid bound within the dressing, and away from the patient's skin. As such, the dressing is designed to decrease dressing change frequency, to reduce the risk of maceration, and to protect the patient's skin from harmful components within wound fluid that can impede wound healing. Does not contain natural rubber latex. OPTIONS: 4" x 5" Non-Adhesive, Pack of 100

Product Information

Specialty absorptive dressings are those that do not fit into other absorptive surgical dressing categories. They often contain a novel or proprietary material or a combination of cotton, rayon, or cellulose, which acts as a super-absorbent wicking dressing. These dressings are often employed as secondary dressings over highly exudative wounds which require frequent dressing changes due to dressing saturation. Many are designed to allow for change of the specialty absorptive layer only, without disruption or the primary dressing or wound bed. These dressings are convenient for placement outside the primary layer of lower extremity compression wraps to allow the compression to remain in place longer, while still adequately managing wound exudate

Pricing and Suppliers

Is it covered by Medicare Part B?

Medicare Part B (Medical Insurance) covers specialty absorptive dressings that are considered medically necessary for treatment of a surgically treated or surgical wound, when requirements are met. Medicare has guidelines that establish what is considered medically necessary and how often an item can be used.

Center for Medicare and Medicaid Services (CMS). Local Coverage Determination for Surgical Dressings (L33831)

How can I purchase this product?

If you have coverage through Medicare Part B, you may be eligible to have this product covered by Medicare. You will need a written order prescribed by a provider enrolled in Medicare, so that you can purchase this product at a Durable Medical Equipment store that accepts Medicare. You will need to pay deductibles and co-payment. The actual co-payment amount varies according to your state. If you do not have Medicare Part B or do not meet the requirements needed for coverage, you can find this product at pharmacies and medical supply stores. Please refer to the table "Other Stores" below for pricing and suggestions on where to purchase this product "out-of-pocket" (without insurance). If there are no vendors listed and you would like to have information on suppliers, please email 

The table below shows highest and lowest Medicare pricing across the country
DescriptionMedicare DME co-payment Min / Max
Absorpt drg >16 <=48 w/o bdr $0.64 / $0.75

The Medicare website indicates that the 0 stores in below carry "" and accept Medicare. However, PRODUCT MAY NOT BE AVAILABLE IN STORE. If using private insurance, please check if your insurance works with these stores.

Recommended Suppliers
Estimated out-of-pocket cost: $309.88

If your insurance does not cover this product, you can purchase it directly from any store. A list of online stores and prices is provided below for your convenience. For updated prices, find it on the internet at

Other Stores

Amazon$309.88 Inquire vendor Inquire vendor Free with Prime  
* Indicates whether store accepts Medicare or commercial insurance, but may not apply to this specific product. See coding, coverage and reimubursement for more information.
The information on this handout is for your convenience and educational purposes only. All product claims and specifications are those of the product suppliers. It does not constitute medical advice or a guarantee for reimbursement. Prices may have changed and suppliers may not have product in stock. Please confirm accuracy and appropriateness of information with insurance carrier and product supplier. Clinician and WoundReference assume no liability for inaccuracies or misstatements about products and insurance coverage.