Billing code 97606: Negative pressure therapyMedicare rate & RVUs

Medicare pays $50.44 for 97606 nationally in the office and $23.05 in a hospital or facility. Local office rates run $45.99–$65.88.

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.

Where 97606 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

97606 rates by state

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

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.

97606 compared with similar codes

How to choose

97605Wound therapy

Both codes involve DME-based negative pressure wound therapy. Choose 97606 for a total treated area greater than 50 square centimeters and 97605 for 50 square centimeters or less.

97608Negative pressure therapy

Both use the greater-than-50-square-centimeter wound-area threshold. The distinction is the equipment: 97606 is for DME, while 97608 is for a disposable non-DME system.

97607Negative pressure therapy

97607 describes disposable non-DME negative pressure therapy for 50 square centimeters or less; 97606 requires DME and an area greater than 50 square centimeters.

Codes related to 97606

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

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