Billing code 97608: Negative pressure therapyMedicare rate & RVUs in Maine
Reports a session of negative pressure wound therapy using disposable equipment when the total treated wound surface area exceeds 50 square centimeters.
Medicare pays $365.46–$392.40 for 97608 in the office in Maine, from Rest Of Maine to Southern Maine. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 97608 covers
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.
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 97608 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | $365.46 | $20.38 |
| Southern Maine | $392.40 | $20.69 |
How the 97608 rate is calculated
Each of 97608’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 · 97608
RVUs × geographic indexes × conversion factor
Work0.45
0.45 RVUs× 1.000 GPCI
Practice expense11.35
11.35 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
11.8800
Conversion factor
$33.4009
Medicare rate
$396.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97608
97608 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 · 97608
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$396.80
- Non-facility (office)
- $396.80
- Facility
- $21.71
Higher because the practice carries its own overhead.
97608 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 97607Negative pressure therapy
- 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.
- 97606Negative pressure therapy
- 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.
- 97605Wound therapy
- 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.
- 97602Wound(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.
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 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
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