Billing code 97598: Wound debridementMedicare rate & RVUs in Virginia
Reports additional selective debridement of open-wound surface area beyond the initial area covered by the primary debridement service.
Medicare pays $46.67–$54.11 for 97598 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 97598 covers
97598 represents additional selective removal of devitalized tissue and wound debris from open wounds, beyond the area covered by the primary service. The clinician works to remove nonviable tissue while preserving viable tissue; the service may involve sharp instruments or other selective methods. Physicians and wound-care clinicians, including physical or occupational therapists, may perform it in settings such as an outpatient wound clinic, hospital outpatient department, or office.
Report 97598 only with its primary code, 97597. Count the additional area debrided in increments of 20 cm² or less; the final increment may be a fraction of 20 cm². Documentation should identify the wound area actually treated, the selective debridement performed, and the tissue removed. CMS classifies 97598 as an add-on code and pays it within the primary procedure's global period.
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 97598 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $54.11 | $23.42 |
| Virginia | $46.67 | $21.06 |
How the 97598 rate is calculated
Each of 97598’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 · 97598
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.49Practice expense 0.88Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 97598
The CMS indicators that decide how 97598 is paid alongside other services.
CMS payment indicators · 97598
Wound debridement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
97598 compared with similar codes
Compare codes
97598 vs 97597 vs 11042 vs 97602: national Medicare rates
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How to choose
- 97597Selective wound debridement
- 97597 covers the initial wound area; 97598 reports each additional 20 cm² or portion. Report 97598 only with 97597.
- 11042Wound debridement
- 11042 is used for excisional debridement into subcutaneous tissue. 97598 is the add-on for additional area treated through selective debridement.
- 97602Wound(s) care non-selective
- 97602 describes nonselective wound debridement. 97598 applies to additional area treated by selective debridement and requires 97597.
97598 billing questions
Can 97598 be reported by itself?
No. It is an add-on code and must be reported with the primary selective debridement service, 97597.
How many units should be reported?
Report one unit for each additional 20 cm² or portion thereof debrided after the area covered by 97597. Base units on the area actually treated, not simply the wound's overall dimensions.
What documentation supports 97598?
Document the wound or wounds treated, the area selectively debrided, and the procedure and tissue removed. The record should support the additional area beyond the primary service.
When should 11042 be considered instead?
Use 11042 when the service is excisional debridement extending into subcutaneous tissue. 97598 describes additional selective debridement and is reported with 97597.
How does the global-period rule affect payment?
CMS treats 97598 as an add-on paid within the global period of its primary procedure. It is not a standalone primary service.
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
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