CPT code 97605: Wound therapy, DME, 50 sq cm or less2026 Medicare rate & RVUs in Rhode Island
Reports a DME-based negative-pressure wound therapy session for one or more wounds whose combined treated surface area is 50 square centimeters or less.
In Rhode Island, Medicare pays $43.17 for 97605 in the office and $21.44 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.
On this page 11 sections
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 Rhode Island 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. Rhode Island pays $43.17. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Rhode Island · this page$43.17
- Los Angeles, CA · California$47.05+$3.88
- Washington, DC area · District of Columbia$47.32+$4.15
- Miami, FL · Florida$43.57+$0.40
- Chicago, IL · Illinois$42.76−$0.41
- Manhattan, NY · New York$47.28+$4.11
- Alaska · Alaska$52.49+$9.32
Other areas in Rhode Island first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $38.98 | $20.56 |
| ArkansasArkansas | $38.58 | $20.50 |
| ArizonaArizona | $41.30 | $20.91 |
| Bakersfield, CACalifornia | $44.57 | $21.51 |
| Chico, CACalifornia | $44.51 | $21.45 |
| El Centro, CACalifornia | $44.52 | $21.45 |
| Fresno, CACalifornia | $44.51 | $21.45 |
| Hanford, CACalifornia | $44.51 | $21.45 |
| Madera, CACalifornia | $44.51 | $21.45 |
| Merced, CACalifornia | $44.51 | $21.45 |
| Modesto, CACalifornia | $44.51 | $21.45 |
| Napa, CACalifornia | $50.60 | $22.86 |
| Oxnard, CACalifornia | $46.78 | $21.91 |
| Redding, CACalifornia | $44.51 | $21.45 |
| Rest of CaliforniaCalifornia | $44.51 | $21.45 |
| Riverside, CACalifornia | $44.64 | $21.57 |
| Sacramento, CACalifornia | $46.44 | $21.97 |
| Salinas, CACalifornia | $46.26 | $21.87 |
| San Diego, CACalifornia | $47.12 | $21.95 |
| Marin County, CACalifornia | $53.34 | $23.67 |
| San Francisco, CACalifornia | $53.33 | $23.66 |
| San Benito County, CACalifornia | $54.40 | $24.05 |
| Santa Clara County, CACalifornia | $54.35 | $24.01 |
| San Luis Obispo, CACalifornia | $45.53 | $21.57 |
| Santa Cruz, CACalifornia | $47.41 | $21.84 |
| Santa Maria, CACalifornia | $46.37 | $21.84 |
| Santa Rosa, CACalifornia | $47.88 | $22.04 |
| Stockton, CACalifornia | $44.51 | $21.45 |
| Vallejo, CACalifornia | $50.58 | $22.85 |
| Visalia, CACalifornia | $44.51 | $21.45 |
| Yuba City, CACalifornia | $44.51 | $21.45 |
| ColoradoColorado | $43.75 | $21.36 |
| ConnecticutConnecticut | $44.34 | $21.68 |
| DelawareDelaware | $41.86 | $21.07 |
| Fort Lauderdale, FLFlorida | $42.66 | $21.35 |
| Rest of FloridaFlorida | $41.21 | $21.09 |
| Atlanta, GAGeorgia | $42.59 | $21.21 |
| Rest of GeorgiaGeorgia | $39.59 | $20.82 |
| Hawaii, Guam, HIHawaii | $45.19 | $21.27 |
| IowaIowa | $39.87 | $20.61 |
| IdahoIdaho | $40.01 | $20.65 |
| East St. Louis, ILIllinois | $40.53 | $21.17 |
| Rest of IllinoisIllinois | $40.21 | $21.00 |
| Suburban Chicago, ILIllinois | $43.11 | $21.50 |
| IndianaIndiana | $40.18 | $20.68 |
| KansasKansas | $39.64 | $20.62 |
| KentuckyKentucky | $39.42 | $20.72 |
| New Orleans, LALouisiana | $40.73 | $20.93 |
| Rest of LouisianaLouisiana | $39.34 | $20.72 |
| Metropolitan Boston, MAMassachusetts | $47.39 | $22.26 |
| Rest of MassachusettsMassachusetts | $43.56 | $21.40 |
| Baltimore area, MDMaryland | $44.18 | $21.61 |
| Rest of MarylandMaryland | $42.52 | $21.23 |
| Rest of MaineMaine | $40.06 | $20.70 |
| Southern Maine, MEMaine | $41.75 | $20.90 |
| Detroit, MIMichigan | $41.48 | $21.18 |
| Rest of MichiganMichigan | $40.07 | $20.85 |
| MinnesotaMinnesota | $42.54 | $20.88 |
| Metropolitan Kansas City, MOMissouri | $40.63 | $20.87 |
| Metropolitan St. Louis, MOMissouri | $40.95 | $20.91 |
| Rest of MissouriMissouri | $38.80 | $20.67 |
| MississippiMississippi | $38.70 | $20.58 |
| MontanaMontana | $42.08 | $21.04 |
| North CarolinaNorth Carolina | $40.38 | $20.74 |
| North DakotaNorth Dakota | $41.89 | $20.84 |
| NebraskaNebraska | $40.05 | $20.63 |
| New HampshireNew Hampshire | $43.02 | $21.11 |
| Northern New JerseyNew Jersey | $47.04 | $22.63 |
| Rest of New JerseyNew Jersey | $45.02 | $22.04 |
| New MexicoNew Mexico | $40.18 | $20.89 |
| NevadaNevada | $42.05 | $20.99 |
| NYC suburbs and Long Island, NYNew York | $48.01 | $22.99 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $45.22 | $22.18 |
| Queens, NYNew York | $47.70 | $22.83 |
| Rest of New YorkNew York | $40.80 | $20.81 |
| OhioOhio | $40.02 | $20.81 |
| OklahomaOklahoma | $39.47 | $20.68 |
| Portland, OROregon | $44.92 | $21.54 |
| Rest of OregonOregon | $41.89 | $20.93 |
| Metropolitan Philadelphia, PAPennsylvania | $43.45 | $21.54 |
| Rest of PennsylvaniaPennsylvania | $40.12 | $20.81 |
| Puerto RicoPuerto Rico | $42.34 | $21.07 |
| South CarolinaSouth Carolina | $40.23 | $20.79 |
| South DakotaSouth Dakota | $41.86 | $20.82 |
| TennesseeTennessee | $39.77 | $20.64 |
| Austin, TXTexas | $43.46 | $21.20 |
| Beaumont, TXTexas | $39.93 | $20.78 |
| Brazoria, TXTexas | $41.94 | $21.09 |
| Dallas, TXTexas | $42.11 | $21.15 |
| Fort Worth, TXTexas | $41.87 | $21.12 |
| Galveston, TXTexas | $42.01 | $21.11 |
| Houston, TXTexas | $42.19 | $21.29 |
| Rest of TexasTexas | $40.84 | $20.87 |
| UtahUtah | $40.63 | $20.85 |
| VirginiaVirginia | $41.58 | $20.90 |
| Virgin Islands, VIUnited States Virgin Islands | $42.34 | $21.07 |
| VermontVermont | $41.68 | $20.85 |
| Rest of WashingtonWashington | $43.50 | $21.34 |
| King County, WAWashington | $48.31 | $22.49 |
| WisconsinWisconsin | $40.86 | $20.70 |
| West VirginiaWest Virginia | $39.12 | $20.84 |
| WyomingWyoming | $42.00 | $20.96 |
97605 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$38.58
$52.49
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $52.49 | 1 |
| AL | $38.98 | 1 |
| AR | $38.58 | 1 |
| AZ | $41.30 | 1 |
| CA | $44.51–$54.40 | 29 |
| CO | $43.75 | 1 |
| CT | $44.34 | 1 |
| DC | $47.32 | 1 |
| DE | $41.86 | 1 |
| FL | $41.21–$43.57 | 3 |
| GA | $39.59–$42.59 | 2 |
| GU | $45.19 | 1 |
| HI | $45.19 | 1 |
| IA | $39.87 | 1 |
| ID | $40.01 | 1 |
| IL | $40.21–$43.11 | 4 |
| IN | $40.18 | 1 |
| KS | $39.64 | 1 |
| KY | $39.42 | 1 |
| LA | $39.34–$40.73 | 2 |
| MA | $43.56–$47.39 | 2 |
| MD | $42.52–$47.32 | 3 |
| ME | $40.06–$41.75 | 2 |
| MI | $40.07–$41.48 | 2 |
| MN | $42.54 | 1 |
| MO | $38.80–$40.95 | 3 |
| MS | $38.70 | 1 |
| MT | $42.08 | 1 |
| NC | $40.38 | 1 |
| ND | $41.89 | 1 |
| NE | $40.05 | 1 |
| NH | $43.02 | 1 |
| NJ | $45.02–$47.04 | 2 |
| NM | $40.18 | 1 |
| NV | $42.05 | 1 |
| NY | $40.80–$48.01 | 5 |
| OH | $40.02 | 1 |
| OK | $39.47 | 1 |
| OR | $41.89–$44.92 | 2 |
| PA | $40.12–$43.45 | 2 |
| PR | $42.34 | 1 |
| RI | $43.17 | 1 |
| SC | $40.23 | 1 |
| SD | $41.86 | 1 |
| TN | $39.77 | 1 |
| TX | $39.93–$43.46 | 8 |
| UT | $40.63 | 1 |
| VA | $41.58–$47.32 | 2 |
| VI | $42.34 | 1 |
| VT | $41.68 | 1 |
| WA | $43.50–$48.31 | 2 |
| WI | $40.86 | 1 |
| WV | $39.12 | 1 |
| WY | $42.00 | 1 |
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.
How the rate is built · 97605
RVUs × geographic indexes × conversion factor
Work0.54
0.54 RVUs× 1.000 GPCI
Practice expense0.71
0.71 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.2600
Conversion factor
$33.4009
Medicare rate
$42.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Rhode Island inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,902
- Code
- 97605
- Physician work
- 0.54
- Practice expense
- 0.71
- Malpractice
- 0.01
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.54 | × 1.019 | 0.5503 |
| Practice expense | 0.71 | × 1.033 | 0.7334 |
| Malpractice | 0.01 | × 0.892 | 0.0089 |
| Total RVUs | 1.2926 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Rhode Island$43.17
Office: (0.54 × 1.019 + 0.71 × 1.033 + 0.01 × 0.892) × $33.4009 = $43.17
Facility: (0.54 × 1.019 + 0.08 × 1.033 + 0.01 × 0.892) × $33.4009 = $21.44
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.
Place of service · 97605
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$42.09
- Non-facility (office)
- $42.09
- Facility
- $21.04
Higher because the practice carries its own overhead.
How 97605 has changed in Rhode Island
97605 · Office / nonfacility
$43.17
Effective 2026-10-01
The base rate is $0.21 lower than on 2025-10-01, moving from $43.38 to $43.17 (0.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$43.38changed to$43.17
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.55 changed to 0.54
- Practice expense RVU 0.74 changed to 0.71
- Work GPCI 1.025 changed to 1.019
- Practice expense GPCI 1.039 changed to 1.033
- Malpractice GPCI 0.849 changed to 0.892
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$44.30changed to$43.38
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.73 changed to 0.74
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$43.57changed to$44.30
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$44.50changed to$43.57
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.71 changed to 0.73
- Work GPCI 1.023 changed to 1.025
- Practice expense GPCI 1.044 changed to 1.039
- Malpractice GPCI 0.915 changed to 0.849
January 1, 2023
RVU23A
$44.77changed to$44.50
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.68 changed to 0.71
- Malpractice RVU 0.02 changed to 0.01
- Work GPCI 1.021 changed to 1.023
- Practice expense GPCI 1.048 changed to 1.044
- Malpractice GPCI 0.981 changed to 0.915
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$44.78changed to$44.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.67 changed to 0.68
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$46.41changed to$44.78
- Conversion factor 36.0896 changed to 34.8931
- Work GPCI 1.024 changed to 1.021
- Practice expense GPCI 1.049 changed to 1.048
- Malpractice GPCI 0.990 changed to 0.981
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$46.43changed to$46.41
- Conversion factor 36.0391 changed to 36.0896
- Work GPCI 1.027 changed to 1.024
- Practice expense GPCI 1.050 changed to 1.049
- Malpractice GPCI 0.999 changed to 0.990
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$46.76changed to$46.43
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.68 changed to 0.67
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$43.52changed to$46.76
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 0.60 changed to 0.68
- Work GPCI 1.025 changed to 1.027
- Practice expense GPCI 1.052 changed to 1.050
- Malpractice GPCI 0.879 changed to 0.999
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$42.91changed to$43.52
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 0.59 changed to 0.60
- Work GPCI 1.022 changed to 1.025
- Practice expense GPCI 1.053 changed to 1.052
- Malpractice GPCI 0.759 changed to 0.879
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$44.98changed to$42.91
- Conversion factor 35.9335 changed to 35.8043
- Malpractice RVU 0.09 changed to 0.02
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$44.75changed to$44.98
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$44.39changed to$44.75
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 0.57 changed to 0.59
- Malpractice RVU 0.08 changed to 0.09
- Work GPCI 1.020 changed to 1.022
- Malpractice GPCI 0.973 changed to 0.759
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$44.39
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $43.17 | $21.44 | RVU26D |
| 2026-07-01 | $43.17 | $21.44 | RVU26C |
| 2026-04-01 | $43.17 | $21.44 | RVU26B |
| 2026-01-01 | $43.17 | $21.44 | RVU26A |
| 2025-10-01 | $43.38 | $24.22 | RVU25D |
| 2025-07-01 | $43.38 | $24.22 | RVU25C |
| 2025-04-01 | $43.38 | $24.22 | RVU25B |
| 2025-01-01 | $43.38 | $24.22 | RVU25A |
| 2024-10-01 | $44.30 | $24.58 | RVU24D |
| 2024-07-01 | $44.30 | $24.58 | RVU24C |
| 2024-04-01 | $44.30 | $24.58 | RVU24B |
| 2024-03-09 | $44.30 | $24.58 | RVU24AR |
| 2024-01-01 | $43.57 | $24.18 | RVU24A |
| 2023-10-01 | $44.50 | $25.39 | RVU23D |
| 2023-07-01 | $44.50 | $25.39 | RVU23C |
| 2023-04-01 | $44.50 | $25.39 | RVU23B |
| 2023-01-01 | $44.50 | $25.39 | RVU23A |
| 2022-10-01 | $44.77 | $25.91 | RVU22D |
| 2022-07-01 | $44.77 | $25.91 | RVU22C |
| 2022-04-01 | $44.77 | $25.91 | RVU22B |
| 2022-01-01 | $44.77 | $25.91 | RVU22A |
| 2021-10-01 | $44.78 | $26.13 | RVU21D |
| 2021-07-01 | $44.78 | $26.13 | RVU21C |
| 2021-04-01 | $44.78 | $26.13 | RVU21B |
| 2021-01-01 | $44.78 | $26.13 | RVU21A |
| 2020-10-01 | $46.41 | $27.48 | RVU20D |
| 2020-07-01 | $46.41 | $27.48 | RVU20C |
| 2020-04-01 | $46.41 | $27.48 | RVU20B |
| 2020-01-01 | $46.41 | $27.48 | RVU20A |
| 2019-10-01 | $46.43 | $27.51 | RVU19D |
| 2019-07-01 | $46.43 | $27.51 | RVU19C |
| 2019-04-01 | $46.43 | $27.51 | RVU19B |
| 2019-01-01 | $46.43 | $27.51 | RVU19A |
| 2018-10-01 | $46.76 | $27.48 | RVU18D |
| 2018-07-01 | $46.76 | $27.48 | RVU18C |
| 2018-04-01 | $46.76 | $27.48 | RVU18B |
| 2018-01-01 | $46.76 | $27.48 | RVU18AR1 |
| 2017-10-01 | $43.52 | $26.15 | RVU17D |
| 2017-07-01 | $43.52 | $26.15 | RVU17C |
| 2017-04-01 | $43.52 | $26.15 | RVU17B |
| 2017-01-01 | $43.52 | $26.15 | RVU17A |
| 2016-10-01 | $42.91 | $25.95 | RVU16D |
| 2016-07-01 | $42.91 | $25.95 | RVU16C |
| 2016-04-01 | $42.91 | $25.95 | RVU16B |
| 2016-01-01 | $42.91 | $25.95 | RVU16A |
| 2015-10-01 | $44.98 | $27.95 | RVU15D |
| 2015-07-01 | $44.98 | $27.95 | RVU15C |
| 2015-04-01 | $44.75 | $27.81 | RVU15B |
| 2015-01-01 | $44.75 | $27.81 | RVU15A |
| 2014-10-01 | $44.39 | $28.17 | RVU14D |
| 2014-07-01 | $44.39 | $28.17 | RVU14C |
| 2014-04-01 | $44.39 | $28.17 | RVU14B |
| 2014-01-01 | $44.39 | $28.17 | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Rhode Island rate applies
Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.
- Ashaway
- Bradford
- Carolina
- Central Falls
- Charlestown
- Chepachet
- Clayville
- Cranston
97605 billing questions
How is the wound-area threshold determined?
Use the combined surface area of the wounds treated during the session. This code is for a total of 50 square centimeters or less; 97606 is for a larger total.
When should 97607 be used instead?
Use 97607 when the negative-pressure system does not require DME and the combined treated wound area is 50 square centimeters or less. The corresponding higher-area code is 97608.
Can the dressing application or wound assessment be billed separately?
Dressing application, wound assessment, and instruction for ongoing care are included in this service. Do not report those included elements as separate wound-care services.
Is the code reported once for each wound?
The area threshold is based on the combined wounds treated in the session, not a separate threshold for each wound. Document the individual wounds and their dimensions to support the total.
How does this differ from 97602?
97605 describes negative-pressure therapy using DME. Code 97602 describes non-selective wound care, such as routine cleansing or dressing care, rather than this suction-based treatment.
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
Show the CMS file lines behind this rate
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