Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 97597 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Dbrdmt Opn Wnd 1st 20 Cm, Debridement Eg High Pressure Waterjet With Without Suction Sharp Selective Debridement With Scissors Scalpel And Forceps Open Wound Eg Fibrin Devitalized Epidermis And Or Dermis Exudate Debris Biofilm Including Topical Application S Wound Assessment Use Of A Whirlpool When Performed And Instruction S For Ongoing Care Per Session Total Wound S Surface Area First 20 Sq Cm Or Less
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service GP - Services delivered under an outpatient physical therapy plan of care |
| Complexity Level | Low |
| Medicare Fee Schedule | $101.54 national non-facility rate (2026) · View Medicare rates for 97597 |
| Medicaid Fee Schedule | $78.73 median of the 7 states in the free preview · View Medicaid rates for 97597 |
National average reimbursement for CPT 97597 by major payers:
$98.45
$84.01
$116.70
$131.82
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 97597.
CPT 97597
5 of 25 sample ratesHigher to lower in this preview
Zain Al-Safi
$517.61Published rateKhalid Arshad
Riverside Health System
$103.76Published rateMagdala Beauvil
$86.09Published rateBetsy Ostrander
Benefis Hospitals Inc
$63.04Published rateKatherine Bohnert
A Woman'S Place, LLC
$23.13Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 97597 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97597 code is part of the Medicine Services and Procedures services used for Physical Medicine and Rehabilitation Evaluations. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 97597 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 97597-CPT | Low | Dbrdmt Opn Wnd 1st 20 Cm, Debridement Eg High Pressure Waterjet With Without Suction Sharp Selective Debridement With Scissors Scalpel And Forceps Open Wound Eg Fibrin Devitalized Epidermis And Or Dermis Exudate Debris Biofilm Including Topical Application S Wound Assessment Use Of A Whirlpool When Performed And Instruction S For Ongoing Care Per Session Total Wound S Surface Area First 20 Sq Cm Or Less |
| 97598-CPT | Low | Dbrdmt Opn Wnd Addl 20cm, Debridement Eg High Pressure Waterjet With Without Suction Sharp Selective Debridement With Scissors Scalpel And Forceps Open Wound Eg Fibrin Devitalized Epidermis And Or Dermis Exudate Debris Biofilm Including Topical Application S Wound Assessment Use Of A Whirlpool When Performed And Instruction S For Ongoing Care Per Session Total Wound S Surface Area Each Additional 20 Sq Cm Or Part Thereof List Separately In Addition To Code For Primary Procedure |
| 97602-CPT | Low | Wound S Care Non Selective, Removal Of Devitalized Tissue From Wound S Non Selective Debridement Without Anesthesia Eg Wet To Moist Dressings Enzymatic Abrasion Larval Therapy Including Topical Application S Wound Assessment And Instruction S For Ongoing Care Per Session |
| 97605-CPT | Low | Neg Prs Wnd Ther Dme 50sqcm, Negative Pressure Wound Therapy Eg Vacuum Assisted Drainage Collection Utilizing Durable Medical Equipment Dme Including Topical Application S Wound Assessment And Instruction S For Ongoing Care Per Session Total Wound S Surface Area Less Than Or Equal To 50 Square Centimeters |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97597 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 97597) and we'll show you how you compare in 15 minutes or less.