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

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.

CMS RVU26DEffective Oct 1, 2026One payment locality38.7K Medicare services in 2024

In Tennessee, Medicare pays $39.77 for 97605 in the office and $20.64 when it’s performed in a hospital or facility.

$39.77Office (non-facility)
$20.64Hospital or facility
−5.5%vs the national office rate ($42.09)

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.

We’ll open 97605 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Tennessee
  2. What 97605 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Tennessee 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. Tennessee pays $39.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

97605 in Tennessee vs other payment areas
  1. Tennessee · this page$39.77
  2. Los Angeles, CA · California$47.05+$7.28
  3. Washington, DC area · District of Columbia$47.32+$7.55
  4. Miami, FL · Florida$43.57+$3.80
  5. Chicago, IL · Illinois$42.76+$2.99
  6. Manhattan, NY · New York$47.28+$7.51
  7. Alaska · Alaska$52.49+$12.72

Other areas in Tennessee first, then benchmark localities. Bars start at $0.

Every other payment area

97605 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
97605 office rate range by state
State / territoryOffice rate rangeLocalities
AK$52.491
AL$38.981
AR$38.581
AZ$41.301
CA$44.51–$54.4029
CO$43.751
CT$44.341
DC$47.321
DE$41.861
FL$41.21–$43.573
GA$39.59–$42.592
GU$45.191
HI$45.191
IA$39.871
ID$40.011
IL$40.21–$43.114
IN$40.181
KS$39.641
KY$39.421
LA$39.34–$40.732
MA$43.56–$47.392
MD$42.52–$47.323
ME$40.06–$41.752
MI$40.07–$41.482
MN$42.541
MO$38.80–$40.953
MS$38.701
MT$42.081
NC$40.381
ND$41.891
NE$40.051
NH$43.021
NJ$45.02–$47.042
NM$40.181
NV$42.051
NY$40.80–$48.015
OH$40.021
OK$39.471
OR$41.89–$44.922
PA$40.12–$43.452
PR$42.341
RI$43.171
SC$40.231
SD$41.861
TN$39.771
TX$39.93–$43.468
UT$40.631
VA$41.58–$47.322
VI$42.341
VT$41.681
WA$43.50–$48.312
WI$40.861
WV$39.121
WY$42.001

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.

How the rate is built · 97605

RVUs × geographic indexes × conversion factor

Office or facility?

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 Tennessee 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

95

Locality
Tennessee
Physician work
1.000
Practice expense
0.909
Malpractice
0.537
Office calculation for 97605 in Tennessee
ComponentRVULocality factorAdjusted
Physician work0.54× 1.0000.5400
Practice expense0.71× 0.9090.6454
Malpractice0.01× 0.5370.0054
Total RVUs1.1908
Conversion factor× 33.4009

Office rate, Tennessee$39.77

Office: (0.54 × 1 + 0.71 × 0.909 + 0.01 × 0.537) × $33.4009 = $39.77

Facility: (0.54 × 1 + 0.08 × 0.909 + 0.01 × 0.537) × $33.4009 = $20.64

Open 97605 in the RVU calculator

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 Tennessee

97605 · Office / nonfacility

$39.77

Effective 2026-10-01

The base rate is $0.36 higher than on 2025-10-01, moving from $39.41 to $39.77 (0.9%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $39.41changed to$39.77

    • 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
    • Practice expense GPCI 0.896 changed to 0.909
    • Malpractice GPCI 0.544 changed to 0.537

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $40.26changed to$39.41

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.73 changed to 0.74

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $39.60changed to$40.26

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $40.32changed to$39.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.71 changed to 0.73
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.518 changed to 0.544
  5. January 1, 2023

    RVU23A

    $40.36changed to$40.32

    • 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
    • Practice expense GPCI 0.892 changed to 0.894
    • Malpractice GPCI 0.492 changed to 0.518

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $40.39changed to$40.36

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.67 changed to 0.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $41.91changed to$40.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense GPCI 0.897 changed to 0.892
    • Malpractice GPCI 0.509 changed to 0.492

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $41.96changed to$41.91

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 0.901 changed to 0.897
    • Malpractice GPCI 0.526 changed to 0.509

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $42.23changed to$41.96

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.68 changed to 0.67

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$42.23

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$39.77$20.64RVU26D
2026-07-01$39.77$20.64RVU26C
2026-04-01$39.77$20.64RVU26B
2026-01-01$39.77$20.64RVU26A
2025-10-01$39.41$22.89RVU25D
2025-07-01$39.41$22.89RVU25C
2025-04-01$39.41$22.89RVU25B
2025-01-01$39.41$22.89RVU25A
2024-10-01$40.26$23.26RVU24D
2024-07-01$40.26$23.26RVU24C
2024-04-01$40.26$23.26RVU24B
2024-03-09$40.26$23.26RVU24AR
2024-01-01$39.60$22.88RVU24A
2023-10-01$40.32$23.96RVU23D
2023-07-01$40.32$23.96RVU23C
2023-04-01$40.32$23.96RVU23B
2023-01-01$40.32$23.96RVU23A
2022-10-01$40.36$24.31RVU22D
2022-07-01$40.36$24.31RVU22C
2022-04-01$40.36$24.31RVU22B
2022-01-01$40.36$24.31RVU22A
2021-10-01$40.39$24.51RVU21D
2021-07-01$40.39$24.51RVU21C
2021-04-01$40.39$24.51RVU21B
2021-01-01$40.39$24.51RVU21A
2020-10-01$41.91$25.72RVU20D
2020-07-01$41.91$25.72RVU20C
2020-04-01$41.91$25.72RVU20B
2020-01-01$41.91$25.72RVU20A
2019-10-01$41.96$25.72RVU19D
2019-07-01$41.96$25.72RVU19C
2019-04-01$41.96$25.72RVU19B
2019-01-01$41.96$25.72RVU19A
2018-10-01$42.23$25.69RVU18D
2018-07-01$42.23$25.69RVU18C
2018-04-01$42.23$25.69RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 97605 for an earlier date of service

Where the Tennessee rate applies

Tennessee is a Medicare payment area, not a city. Our Census mapping connects it to 504 cities and communities in Tennessee. Some span more than one payment area; confirm with the service ZIP.

  • Adams
  • Adamsville
  • Alamo
  • Alcoa
  • Alexandria
  • Algood
  • Allardt
  • Altamont

Browse all communities in Tennessee

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
RVUs for 97605PPRRVU2026_Oct_nonQPP.csv, line 12,902 (RVU26D)
Geographic factors for TennesseeGPCI2026.csv, line 95 (RVU26D)

Open CMS sourceHow we calculate rates

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