CPT 97605 Fee Schedule

Last Verified: July 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.

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

Key Fact	Detail
Service Type	Active Wound Care Management Physical Medicine and Rehabilitation Evaluations
Common Place of Service	21 - Inpatient Hospital 11 - Office
Common Modifiers	None 59 - Distinct Procedural Service GP - Services delivered under an outpatient physical therapy plan of care
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 97605

National average reimbursement for CPT 97605 by major payers:

$48.57

$42.52

$55.95

$65.77

Preview provider-level rates for...

For billing codeCPT 97605

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	97605	$44.75	1467864116 - KARL REISIG	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Family Medicine Physician (207Q00000X)
United	97605	$44.75	1831252626 - CHRISTINA OLSON	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Hospitalist Physician (208M00000X)
United	97605	$42.09	1043384035 - MICHAEL MIKHAIL	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Medical Oncology Physician (207RX0202X)
United	97605	$44.75	1750975322 - AMBER PYZIK	840744042 - (CO) COLORADO SURGICAL SERVICE P.C.	MD	Acute Care Nurse Practitioner (363LA2100X)
United	97605	$44.75	1841621570 - MARY CARSON	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Pediatric Nurse Practitioner (363LP0200X)
United	97605	$44.75	1841556388 - ASHLEY WHYTE-RAYSON	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Neurology Physician (2084N0400X)
United	97605	$26.70	1730235359 - JASON HATCH	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Interventional Cardiology Physician (207RI0011X)
United	97605	$44.75	1649632076 - ANAND SHAH	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	MD	Critical Care Medicine (Internal Medicine) Physician (207RC0200X)
United	97605	$31.56	1912276957 - FELICIA GREHER	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Clinical Psychologist (103TC0700X)
United	97605	$44.75	1962088310 - GE YAN	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Pediatrics Physician (208000000X)
United	97605	$42.09	1598737975 - KIMBERLY RACINE	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Physician Assistant (363A00000X)
United	97605	$44.75	1073116018 - CHARLENE HAMRICK	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Speech-Language Pathologist (235Z00000X)
United	97605	$44.75	1760443345 - JENNIFER CARROL	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Physician Assistant (363A00000X)
United	97605	$44.75	1396304705 - LAURA ROSENHAHN	742161737 - UNIVERSITY PHYSICIANS INCORPORATED	CO	Family Nurse Practitioner (363LF0000X)
United	97605	$44.75	1245491109 - MARTIN MUSI	800348943 - POUDRE VALLEY MEDICAL GROUP LLC	CO	Emergency Medicine Physician (207P00000X)
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist
United	99202	$100.00	1234567890	1234567890	CA	Cardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Run a free sample report

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

Explore state-level rates for free

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 97605 vs. Other Physical Medicine and Rehabilitation Evaluations Codes

The CPT 97605 code is part of the Active Wound Care Management 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 97605 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 97605. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 97605 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 97605) and we'll show you how you compare in 15 minutes or less.

Schedule a Demo