CPT code 97606: Negative pressure therapy, DME, over 50 sq cm2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $56.95 for 97606 in the office and $24.68 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 97606 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 97606 covers

This service covers a session managing negative pressure wound therapy delivered with durable medical equipment, such as a pump-based vacuum system. The treating clinician assesses the wound, applies or manages the therapy dressings, and provides care instructions as part of the session. It is used for wounds requiring negative pressure treatment in settings such as a physician office or hospital outpatient department.

Select this code when the total surface area of the wound or wounds treated during the session is greater than 50 square centimeters and the equipment is durable medical equipment. Document the wound locations and measurements, the combined area, use of the DME system, and the work performed during the session. The code is reported per session, rather than per wound or dressing. CMS assigns work, practice expense, and malpractice RVUs; the practice expense RVU differs between office and facility settings.

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 Washington, DC area compares for 97606

Across 109 of 109 payment localities, the office rate for 97606 runs from $45.99 in Arkansas to $65.88 in San Benito County, CA. Washington, DC area pays $56.95. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

97606 rates by state

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

See 97606 in every payment locality

How the 97606 rate is calculated

Each of 97606’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 97606

97606 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 97606

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

How 97606 has changed in Washington, DC area

Price 97606 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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