$40.21–$43.11
Choose 97607 for nonpowered disposable equipment and 97605 for powered equipment supplied as DME; both cover a combined area of 50 cm² or less.
On this page
CMS RVU26D · Effective 2026-10-01
97607 Negative pressure therapy Medicare reimbursement rates in Illinois
Report this service for applying disposable, nonpowered negative-pressure wound therapy to one or more wounds with a combined surface area of 50 cm² or less. Compare 97607 office and facility rates across CMS payment localities in Illinois.
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 97607 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$337.91–$378.56
4 of 4 localities have a supported rate.
Facility setting
$19.54–$21.41
4 of 4 localities have a supported rate.
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.
Where 97607 pays more and less in Illinois
4 payment localities
$337.91 to $378.56
Wound care
About 97607: Disposable negative pressure wound therapy
Report this service for applying disposable, nonpowered negative-pressure wound therapy to one or more wounds with a combined surface area of 50 cm² or less.
This service covers applying a disposable, nonpowered negative-pressure system to one or more wounds, with a combined treated surface area no greater than 50 cm². It may be used for wound management when negative pressure is selected to support drainage and healing, including care of chronic ulcers or postoperative wounds. The clinician applies the system and topical materials, assesses the wound, and gives instructions for continuing care; provision of the disposable equipment is included.
Select this code when the system is nonpowered and the total surface area treated during the session is 50 cm² or less. Use the related powered-equipment code when the service uses DME, or the larger-area code when nonpowered therapy covers more than 50 cm². Document the device type, wound dimensions and total area, assessment, application, and care instructions. Application, topical materials, wound assessment, and instructions are elements of this service.
Where the value comes from
- Work RVU0.40 · 4%
- Practice expense (office) RVU10.54 · 96%
- Malpractice RVU0.06 · 1%
11.8K
Medicare services in 2024 · #1383 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.
97607 compared with similar codes
Office rates for Illinois, from the same CMS release.
$47.98–$51.65
97606 describes powered negative-pressure therapy supplied as DME for a combined wound area greater than 50 cm². 97607 is nonpowered and limited to 50 cm² or less.
$365.33–$409.21
Both describe nonpowered disposable negative-pressure therapy, but 97608 applies when the combined wound area exceeds 50 cm².
97602
No office rateWound(s) care non-selective
97602 is for nonselective wound care, not application of the disposable negative-pressure system and related care included in 97607.
Compare 97607 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$371.86
Facility
$21.41
East St. Louis →
Office / nonfacility
$341.28
Facility
$20.47
Rest Of Illinois →
Office / nonfacility
$337.91
Facility
$19.54
Suburban Chicago →
Office / nonfacility
$378.56
Facility
$20.44
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97607 billing questions
How does 97607 differ from 97605?
Both cover negative-pressure wound therapy for a total wound area of 50 cm² or less. 97607 is for nonpowered disposable equipment; 97605 is for powered equipment supplied as DME.
Which code applies when the treated area is exactly 50 cm²?
For nonpowered disposable therapy, 97607 covers a combined treated area of exactly 50 cm². Use 97608 when the combined area exceeds 50 cm².
Is the code reported once for each wound?
The service is reported per session, and code selection is based on the combined surface area of the wound or wounds treated during that session.
Can the application and wound assessment be billed separately?
Application, topical materials, wound assessment, instructions for ongoing care, and provision of disposable equipment are included in this service.
What documentation supports 97607?
Record the device type, dimensions and combined area of the wounds treated, wound findings, therapy application, and instructions given for ongoing care.
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.
12,90197602,,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
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