CPT 97606 Physical Therapy/Rehab

How Much Does Physical Therapy - Negative Pressure Wound Therapeutic DME>50 Sq Cm Cost?

Also known as: Neg prs wnd ther dme>50 sqcm (CPT 97606)

Negative pressure wound therapy (wound VAC) for a larger wound area.

Physical Therapy - Negative Pressure Wound Therapeutic DME>50 Sq Cm (CPT 97606) costs $23 at Medicare rates.

Medicare (Facility)
$23
CMS PFS 2026 national rate
Medicare Physician Fee (Office/Clinic)
$50
Non-facility setting

Patient Guide: Physical Therapy - Negative Pressure Wound Therapeutic DME>50 Sq Cm

What you need to know before your appointment

What to Expect

A vacuum-assisted closure system is applied to a larger wound to promote healing through continuous suction.

How Long Does It Take?

Continuous therapy; dressing changed every 2-3 days

Common Reasons Doctors Order This

Large open wounds, complex wound management, promoting granulation tissue formation

How to Prepare

Keep the device running. Report any alarms. Do not disconnect for more than 2 hours.

Procedures Commonly Done Together

These procedures are frequently performed alongside Neg prs wnd ther dme>50 sqcm

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How to Reduce Your Cost for Neg prs wnd ther dme>50 sqcm

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($50) differs from the facility rate ($23). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

0.59
Work RVU
0.09
Practice Expense RVU
0.01
Malpractice RVU
1.51
Total RVU

Payment = Total RVU (1.51) x CF ($33.40) = $50

Frequently Asked Questions

How much does Neg prs wnd ther dme>50 sqcm cost?

The Medicare facility rate for Neg prs wnd ther dme>50 sqcm is $23. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Neg prs wnd ther dme>50 sqcm cost without insurance?

Without insurance, the cost of Neg prs wnd ther dme>50 sqcm can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Neg prs wnd ther dme>50 sqcm?

Most commercial health insurance plans and Medicare cover Neg prs wnd ther dme>50 sqcm when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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