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

Reports a session of negative pressure wound therapy using durable medical equipment when the combined treated wound surface area exceeds 50 square centimeters.

CMS RVU26DEffective Oct 1, 2026One payment locality14.4K Medicare services in 2024

In Vermont, Medicare pays $49.97 for 97606 in the office and $22.85 when it’s performed in a hospital or facility.

$49.97Office (non-facility)
$22.85Hospital or facility
−0.9%vs the national office rate ($50.44)

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.

We’ll open 97606 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 97606 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 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 Vermont 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. Vermont pays $49.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

97606 in Vermont vs other payment areas
  1. Vermont · this page$49.97
  2. Los Angeles, CA · California$56.69+$6.72
  3. Washington, DC area · District of Columbia$56.95+$6.98
  4. Miami, FL · Florida$52.19+$2.22
  5. Chicago, IL · Illinois$51.16+$1.19
  6. Manhattan, NY · New York$56.82+$6.85
  7. Alaska · Alaska$62.11+$12.14

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

Every other payment area

97606 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$46.49$22.53
ArkansasArkansas$45.99$22.46
ArizonaArizona$49.45$22.91
Bakersfield, CACalifornia$53.60$23.58
Chico, CACalifornia$53.53$23.52
El Centro, CACalifornia$53.53$23.52
Fresno, CACalifornia$53.53$23.52
Hanford, CACalifornia$53.53$23.52

97606 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.

$45.99

$62.11

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
97606 office rate range by state
State / territoryOffice rate rangeLocalities
AK$62.111
AL$46.491
AR$45.991
AZ$49.451
CA$53.53–$65.8829
CO$52.541
CT$53.241
DC$56.951
DE$50.141
FL$49.27–$52.193
GA$47.22–$51.052
GU$54.461
HI$54.461
IA$47.651
ID$47.831
IL$47.98–$51.654
IN$48.041
KS$47.351
KY$47.031
LA$46.93–$48.692
MA$52.29–$57.102
MD$50.97–$56.953
ME$47.88–$50.042
MI$47.83–$49.602
MN$51.081
MO$46.23–$48.983
MS$46.121
MT$50.431
NC$48.281
ND$50.241
NE$47.891
NH$51.641
NJ$54.05–$56.562
NM$47.981
NV$50.411
NY$48.82–$57.735
OH$47.791
OK$47.111
OR$50.21–$54.042
PA$47.92–$52.102
PR$50.761
RI$51.781
SC$48.081
SD$50.211
TN$47.511
TX$47.68–$52.208
UT$48.581
VA$49.82–$56.952
VI$50.761
VT$49.971
WA$52.22–$58.262
WI$48.931
WV$46.601
WY$50.351

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.

How the rate is built · 97606

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.59

0.59 RVUs× 1.000 GPCI

Practice expense0.91

0.91 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

1.5100

Conversion factor

$33.4009

Medicare rate

$50.44

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,903

Code
97606
Physician work
0.59
Practice expense
0.91
Malpractice
0.01

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 97606 in Vermont
ComponentRVULocality factorAdjusted
Physician work0.59× 1.0000.5900
Practice expense0.91× 0.9900.9009
Malpractice0.01× 0.5060.0051
Total RVUs1.4960
Conversion factor× 33.4009

Office rate, Vermont$49.97

Office: (0.59 × 1 + 0.91 × 0.99 + 0.01 × 0.506) × $33.4009 = $49.97

Facility: (0.59 × 1 + 0.09 × 0.99 + 0.01 × 0.506) × $33.4009 = $22.85

Open 97606 in the RVU calculator

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.

Place of service · 97606

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$50.44

Non-facility (office)
$50.44
Facility
$23.05

Higher because the practice carries its own overhead.

How 97606 has changed in Vermont

97606 · Office / nonfacility

$49.97

Effective 2026-10-01

The base rate is $0.20 higher than on 2025-10-01, moving from $49.77 to $49.97 (0.4%).

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

    $49.77changed to$49.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.60 changed to 0.59
    • Practice expense RVU 0.94 changed to 0.91
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $50.56changed to$49.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.92 changed to 0.94

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $49.73changed to$50.56

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $51.26changed to$49.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.91 changed to 0.92
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $50.95changed to$51.26

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.86 changed to 0.91
    • Malpractice RVU 0.02 changed to 0.01
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $51.02changed to$50.95

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.85 changed to 0.86

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $52.63changed to$51.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.84 changed to 0.85
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $52.78changed to$52.63

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $53.45changed to$52.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.86 changed to 0.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $49.54changed to$53.45

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.76 changed to 0.86
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $48.93changed to$49.54

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.75 changed to 0.76
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $51.31changed to$48.93

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.11 changed to 0.02

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $51.06changed to$51.31

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $44.61changed to$51.06

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.58 changed to 0.75
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$44.61

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$49.97$22.85RVU26D
2026-07-01$49.97$22.85RVU26C
2026-04-01$49.97$22.85RVU26B
2026-01-01$49.97$22.85RVU26A
2025-10-01$49.77$25.36RVU25D
2025-07-01$49.77$25.36RVU25C
2025-04-01$49.77$25.36RVU25B
2025-01-01$49.77$25.36RVU25A
2024-10-01$50.56$26.09RVU24D
2024-07-01$50.56$26.09RVU24C
2024-04-01$50.56$26.09RVU24B
2024-03-09$50.56$26.09RVU24AR
2024-01-01$49.73$25.67RVU24A
2023-10-01$51.26$26.60RVU23D
2023-07-01$51.26$26.60RVU23C
2023-04-01$51.26$26.60RVU23B
2023-01-01$51.26$26.60RVU23A
2022-10-01$50.95$27.39RVU22D
2022-07-01$50.95$27.39RVU22C
2022-04-01$50.95$27.39RVU22B
2022-01-01$50.95$27.39RVU22A
2021-10-01$51.02$27.62RVU21D
2021-07-01$51.02$27.62RVU21C
2021-04-01$51.02$27.62RVU21B
2021-01-01$51.02$27.62RVU21A
2020-10-01$52.63$28.62RVU20D
2020-07-01$52.63$28.62RVU20C
2020-04-01$52.63$28.62RVU20B
2020-01-01$52.63$28.62RVU20A
2019-10-01$52.78$28.64RVU19D
2019-07-01$52.78$28.64RVU19C
2019-04-01$52.78$28.64RVU19B
2019-01-01$52.78$28.64RVU19A
2018-10-01$53.45$28.61RVU18D
2018-07-01$53.45$28.61RVU18C
2018-04-01$53.45$28.61RVU18B
2018-01-01$53.45$28.61RVU18AR1
2017-10-01$49.54$27.43RVU17D
2017-07-01$49.54$27.43RVU17C
2017-04-01$49.54$27.43RVU17B
2017-01-01$49.54$27.43RVU17A
2016-10-01$48.93$27.36RVU16D
2016-07-01$48.93$27.36RVU16C
2016-04-01$48.93$27.36RVU16B
2016-01-01$48.93$27.36RVU16A
2015-10-01$51.31$29.67RVU15D
2015-07-01$51.31$29.67RVU15C
2015-04-01$51.06$29.52RVU15B
2015-01-01$51.06$29.52RVU15A
2014-10-01$44.61$29.11RVU14D
2014-07-01$44.61$29.11RVU14C
2014-04-01$44.61$29.11RVU14B
2014-01-01$44.61$29.11RVU14A
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 97606 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

97606 billing questions

How is this code distinguished from 97605?

Both describe DME-based negative pressure wound therapy. Use 97606 when the combined treated wound surface area is greater than 50 square centimeters; 97605 is for 50 square centimeters or less.

Does the wound area refer to each wound or all wounds treated?

Use the combined surface area of the wound or wounds treated during the session. Document the individual measurements and the total used to select the code.

When is 97608 used instead?

97608 describes negative pressure wound therapy for a total wound area greater than 50 square centimeters using a disposable, non-DME system. This code is for DME.

Is the code reported per wound or per session?

It is reported per session. The code selection reflects the total area treated in that session, not the number of wounds or dressings.

What documentation supports reporting this code?

Record wound locations and measurements, the combined treated area, use of a DME negative pressure system, and the therapy management performed during the session.

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 97606PPRRVU2026_Oct_nonQPP.csv, line 12,903 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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