$389.66
Both use disposable negative pressure equipment. Choose 97608 for a combined treated area greater than 50 square centimeters and 97607 for 50 square centimeters or less.
On this page
CMS RVU26D · Effective 2026-10-01
97608 Negative pressure therapy Medicare reimbursement rates in Colorado
Reports a session of negative pressure wound therapy using disposable equipment when the total treated wound surface area exceeds 50 square centimeters. Compare 97608 office and facility rates across CMS payment localities in Colorado.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 97608 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$420.66
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$21.56
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Wound care
About 97608: Disposable negative pressure wound therapy, large area
Reports a session of negative pressure wound therapy using disposable equipment when the total treated wound surface area exceeds 50 square centimeters.
This service covers a session of negative pressure wound therapy delivered with disposable equipment. A wound-care clinician may use it for wounds such as chronic ulcers, pressure injuries, diabetic wounds, or surgical wounds that need negative pressure treatment. The service includes the treatment application, wound assessment, and instruction for ongoing care, and may be performed in settings where wound care is provided.
Select this code when the total surface area of the treated wound or wounds is greater than 50 square centimeters and the system is disposable. Document the equipment type, wound dimensions supporting the combined area, assessment, and care provided during the session. The size threshold is based on the total area of the wound or wounds treated, rather than requiring each wound to exceed 50 square centimeters.
Where the value comes from
- Work RVU0.45 · 4%
- Practice expense (office) RVU11.35 · 96%
- Malpractice RVU0.08 · 1%
2.4K
Medicare services in 2024 · #2341 by national volume
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.
97608 compared with similar codes
Office rates for Colorado, from the same CMS release.
$52.54
The area threshold is greater than 50 square centimeters for both codes. The equipment distinguishes them: 97608 uses disposable equipment, while 97606 uses durable medical equipment.
$43.75
Both use durable medical equipment, not disposable equipment. 97605 is for a total treated area of 50 square centimeters or less; 97608 is for a larger area with disposable equipment.
97602
No office rateWound(s) care non-selective
97602 describes nonselective wound care, whereas 97608 describes a session of negative pressure treatment using disposable equipment for a total area greater than 50 square centimeters.
Compare 97608 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Colorado →
Office / nonfacility
$420.66
Facility
$21.56
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 97608 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
12,905
- Code
- 97608
- Physician work
- 0.45
- Practice expense
- 11.35
- Malpractice
- 0.08
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.45 | × 1.012 | 0.4554 |
| Practice expense | 11.35 | × 1.064 | 12.0764 |
| Malpractice | 0.08 | × 0.781 | 0.0625 |
| Total RVUs | 12.5943 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$420.66
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.45 | 1.012 |
| Practice expense | 11.35 | 1.064 |
| Malpractice | 0.08 | 0.781 |
(0.45 × 1.012 + 11.35 × 1.064 + 0.08 × 0.781) × $33.4009 = $420.66
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.45 | 1.012 |
| Practice expense | 0.12 | 1.064 |
| Malpractice | 0.08 | 0.781 |
(0.45 × 1.012 + 0.12 × 1.064 + 0.08 × 0.781) × $33.4009 = $21.56
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
97608 billing questions
When should 97608 be selected instead of 97607?
Both describe disposable negative pressure wound therapy. Use 97608 when the total treated wound area is greater than 50 square centimeters; 97607 is for 50 square centimeters or less.
How does 97608 differ from 97606?
The wound-area threshold is the same, but 97608 is for disposable equipment and 97606 is for durable medical equipment.
How is the wound-area threshold determined when treating multiple wounds?
Use the combined surface area of the wounds treated during the session. The combined area must exceed 50 square centimeters for 97608.
Are wound assessment and care instructions included?
Yes. The session includes wound assessment and instructions for ongoing care, along with the negative pressure treatment application.
What documentation supports reporting 97608?
Document that disposable negative pressure equipment was used, identify the wounds treated, and record dimensions supporting a combined surface area greater than 50 square centimeters.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,90297605,,Neg prs wnd ther dme<=50sqcm,A,,0.54,0.71,,0.08,,0.01,1.26,0.63,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90397606,,Neg prs wnd ther dme>50 sqcm,A,,0.59,0.91,,0.09,,0.01,1.51,0.69,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90497607,,Neg prs wnd thr ndme<=50sqcm,A,,0.40,10.54,,0.10,,0.06,11.00,0.56,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90597608,,Neg prs wnd ther ndme>50sqcm,A,,0.45,11.35,,0.12,,0.08,11.88,0.65,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90697610,,Low frequency non-thermal us,A,,0.39,11.50,,0.06,,0.01,11.90,0.46,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90797750,,Physical performance test,A,,0.45,0.55,,0.55,NA,0.01,1.01,1.01,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90897755,,Assistive technology assess,A,,0.62,0.50,,0.50,NA,0.01,1.13,1.13,7,XXX,0.00,0.00,0.00,5,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899