CPT 97598: Selective Debridement, Additional 20 cm2
Medicare pays $49 and commercial payers pay $161 on average nationally for this procedure.
CPT code 97598 describes selective removal of devitalized tissue from an open wound for each additional 20 cm² (or part thereof) after the initial 20 cm² has been debrided at the same encounter; the procedure may use sharp instruments or high‑pressure waterjet with or without suction, can include excision of deep or superficial tissue and removal of clots, debris, or biofilm, and may include topical applications, wound assessment, whirlpool when performed, and instructions for ongoing care. Service type: selective wound debridement (additional area). Typical site of service: outpatient clinic, wound care center, or hospital outpatient department.
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
National averages show Medicare at a mean of $49.3 for CPT 97598 versus BUCA’s higher commercial mean of $161.1, indicating BUCA pays about $111.8 more on average than Medicare. That difference underscores a substantial gap between a federal fee schedule–based payer and an aggregated commercial benchmark, with Medicare also reporting a tight interquartile spread (P75 $51 minus P25 $46 = $5), implying relatively consistent locality rates across its 47 localities. Dispersion across commercial payers varies notably: Blue Cross Blue Shield exhibits the widest IQR (P75 $308.8 minus P25 $197.1 = $111.7), signaling substantial variability in contracted rates, while Aetna (P75 $43 minus P25 $14.1 = $28.9) and UnitedHealth Group (P75 $53.8 minus P25 $26.9 = $26.9) show the tightest interquartile ranges among the commercial carriers, suggesting more concentration around their medians.