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See a sample rate comparisonCPT 97602 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Physical Medicine and Rehabilitation Evaluations |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | GP - Services delivered under an outpatient physical therapy plan of care 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 97602 |
| Medicaid Fee Schedule | $27.45 median of the 8 states in the free preview · View Medicaid rates for 97602 |
National average reimbursement for CPT 97602 by major payers:
$88.38
$60.08
$77.34
$63.19
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CPT 97602
5 of 25 sample ratesHigher to lower in this preview
Tushar Advani
$163.55Published ratePriti Singh
Associates In Pediatric Neurology Sc
$129.36Published rateElizabeth Harari
$90.08Published rateRolando Henriquez
Progressive Medical Center, S.C.
$76.58Published rateNicholas Hatzis
$32.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 97602 vs. Other Physical Medicine and Rehabilitation Evaluations Codes
The CPT 97602 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 97602 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 97602. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97602 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.
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Frequently Asked Questions
To find out the cost of a specific medical procedure, you can start by contacting your healthcare provider's billing department for an estimate. It's also advisable to contact your insurance company to understand your coverage, deductible, copay, and coinsurance responsibilities. For a more comprehensive search based on CPT code and specific location, you can use Payerprice's fee schedule lookup tool.
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians, allied health professionals, and payers to describe medical, surgical, and diagnostic services and procedures performed in inpatient and outpatient settings. They are crucial for accurate medical billing and for processing insurance claims, ensuring standardized communication about services rendered.
Fee schedules for medical services can be complex as they vary by payer, provider, and geographic location. While some information might be available through your insurance provider, a centralized, easy-to-access resource can be challenging to find. For a convenient way to search for fee schedules using a CPT code and specific location, Payerprice offers a dedicated lookup tool.
Yes, there is! Payerprice offers a fee schedule lookup tool specifically designed for this purpose. You can use their tool to search for prices of medical procedures by entering the CPT code and your specific location, helping you understand potential costs in your area.
Prices for the same medical service can vary significantly due to several factors. These include differing contracts between healthcare providers and various insurance companies, the type of facility (e.g., hospital vs. outpatient clinic), geographic location, the specific provider's fees, and whether the service is in-network or out-of-network for a patient's insurance plan. The complexity of the healthcare billing system and lack of price transparency also contribute to these variations.