CPT code 97605: Wound therapy, DME, 50 sq cm or less2026 Medicare rate & RVUs in Queens, NY

In Queens, NY, Medicare pays $47.70 for 97605 in the office and $22.83 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 97605 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 97605 covers

Code 97605 represents a session of negative-pressure wound therapy delivered with equipment that qualifies as durable medical equipment, when the combined surface area of treated wounds is 50 square centimeters or less. A sealed dressing connected to suction helps manage an open wound by drawing away fluid. Surgeons and wound-care clinicians commonly oversee this treatment in outpatient wound clinics and postoperative care. Dressing application, wound assessment, and patient or caregiver instruction for ongoing care are included.

Select the area tier using the combined surface area of wounds treated in the session, not the number of wounds; 97606 is used when the total exceeds 50 square centimeters. The equipment pathway also matters: use 97607 or 97608 for systems that do not require DME, applying the same area threshold. Document the treated wounds and their dimensions, equipment used, therapy provided, assessment, and instruction. CMS assigns work, practice-expense, and malpractice RVUs, with separate office and facility practice-expense inputs in the fee schedule.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Queens, NY compares for 97605

Across 109 of 109 payment localities, the office rate for 97605 runs from $38.58 in Arkansas to $54.40 in San Benito County, CA. Queens, NY pays $47.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

97605 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 97605 in every payment locality

How the 97605 rate is calculated

Each of 97605’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 97605

97605 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Codes related to 97605

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 97605 has changed in Queens, NY

Price 97605 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

• 97605 in New York · multiple payment areas

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Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates