CPT 97597: Selective Debridement of Open Wound ≤20 cm²
Medicare pays $106 and commercial payers pay $173 on average nationally for this procedure.
CPT code 97597 describes selective excision of devitalized tissue from an open wound (debridement) using techniques that may include topical agents, wound assessment, whirlpool therapy, and patient instruction; the service is for active wound care management of a treated wound surface area 20 cm2 or less, typically provided in outpatient wound care clinics, physician offices, or ambulatory care settings by authorized clinicians.
For related coverage guidance, see recent payer policy updates: Home Health, Skilled, and Custodial Care Services (for Idaho Only), Private Duty Nursing Services (for Florida Only), Private Duty Nursing Services.
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National Reimbursement Benchmarks
Medicare’s mean rate of $105.6 for CPT 97597 sits between commercial BUCA’s mean of $173.1 and several national commercial payers, indicating Medicare pays closer to the middle of the market rather than the commercial average. Blue Cross Blue Shield’s mean ($242.9) and Aetna’s mean ($68.9) illustrate how commercial payers can cluster above or below Medicare, with BUCA representing a higher-than-Medicare commercial average by about $67.5.
Dispersion measured as the interquartile range (P75 − P25) varies noticeably: Blue Cross Blue Shield is the widest with a range of $121.5, reflecting substantial variability across contracts or regions, while Aetna and UnitedHealth Group are comparatively tight at ranges of $66.0 and $48.7 respectively. Cigna’s range is $66.8 and BUCA’s is $95.2, so the tightest payers are UnitedHealth Group and Aetna and the widest is Blue Cross Blue Shield.