$44.34
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.
On this page
CMS RVU26D · Effective 2026-10-01
97606 Negative pressure therapy Medicare reimbursement rates in Connecticut
Reports a session of negative pressure wound therapy using durable medical equipment when the combined treated wound surface area exceeds 50 square centimeters. Compare 97606 office and facility rates across CMS payment localities in Connecticut.
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 97606 in Connecticut?
Connecticut 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
$53.24
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$23.74
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 97606: Large-area durable equipment wound therapy
Reports a session of negative pressure wound therapy using durable medical equipment when the combined treated wound surface area exceeds 50 square centimeters.
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.
Where the value comes from
- Work RVU0.59 · 39%
- Practice expense (office) RVU0.91 · 60%
- Malpractice RVU0.01 · 1%
14.4K
Medicare services in 2024 · #1280 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.
97606 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$426.86
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.
$395.21
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.
Compare 97606 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
Connecticut →
Office / nonfacility
$53.24
Facility
$23.74
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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 97606 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
12,903
- Code
- 97606
- Physician work
- 0.59
- Practice expense
- 0.91
- Malpractice
- 0.01
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.020 | 0.6018 |
| Practice expense | 0.91 | × 1.077 | 0.9801 |
| Malpractice | 0.01 | × 1.210 | 0.0121 |
| Total RVUs | 1.5940 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$53.24
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1.02 |
| Practice expense | 0.91 | 1.077 |
| Malpractice | 0.01 | 1.21 |
(0.59 × 1.02 + 0.91 × 1.077 + 0.01 × 1.21) × $33.4009 = $53.24
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1.02 |
| Practice expense | 0.09 | 1.077 |
| Malpractice | 0.01 | 1.21 |
(0.59 × 1.02 + 0.09 × 1.077 + 0.01 × 1.21) × $33.4009 = $23.74
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.
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 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.
12,90097598,,Dbrdmt opn wnd addl 20cm/<,A,,0.49,0.88,,0.10,,0.06,1.43,0.65,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,90197602,,Wound(s) care non-selective,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
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
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808