Billing code 97607: Negative pressure therapyMedicare rate & RVUs in Missouri
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.
Medicare pays $318.78–$350.52 for 97607 in the office in Missouri, from Rest Of Missouri to Metropolitan St. Louis. 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 97607 covers
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.
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 97607 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$318.78 to $350.52
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | $345.89 | $18.45 |
| Metropolitan St. Louis | $350.52 | $18.55 |
| Rest Of Missouri | $318.78 | $18.19 |
How the 97607 rate is calculated
Each of 97607’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 · 97607
RVUs × geographic indexes × conversion factor
Work0.40
0.40 RVUs× 1.000 GPCI
Practice expense10.54
10.54 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
11.0000
Conversion factor
$33.4009
Medicare rate
$367.41
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 97607
97607 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 · 97607
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$367.41
- Non-facility (office)
- $367.41
- Facility
- $18.70
Higher because the practice carries its own overhead.
97607 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 97605Wound therapy
- Choose 97607 for nonpowered disposable equipment and 97605 for powered equipment supplied as DME; both cover a combined area of 50 cm² or less.
- 97606Negative pressure therapy
- 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.
- 97608Negative pressure therapy
- Both describe nonpowered disposable negative-pressure therapy, but 97608 applies when the combined wound area exceeds 50 cm².
- 97602Wound(s) care non-selective
- 97602 is for nonselective wound care, not application of the disposable negative-pressure system and related care included in 97607.
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 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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