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CPT 97607: Negative Pressure Wound Therapy for Small Wounds
CPT code 97607 identifies negative pressure wound therapy (NPWT) applied to wounds with a total surface area of 50 cm2 or less. The procedure uses controlled subatmospheric pressure via a sealed dressing to remove fluids and infectious material and promote healing of slow-healing or nonhealing wounds, including decubitus ulcers. Nationally, this code matters because NPWT is a commonly used modality in wound management and influences utilization patterns, site-of-service decisions, and payer coverage policies.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical indications and typical settings for CPT code 97607, plus discussion of how payers approach coverage and billing for small-surface-area NPWT. The publication summarizes common billing modifiers and administrative considerations where available, and highlights practical coding context such as service type and typical sites of service.
This analysis is intended for clinicians, billing professionals, and policy stakeholders who need a clear, national-level reference on CPT code 97607, its clinical role in wound care, and the payer landscape relevant to coverage and reimbursement administration. Data not available in the input will be noted explicitly where applicable.
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Billing Code Overview
CPT code 97607 describes the application of controlled subatmospheric pressure (negative pressure wound therapy) around a wound through a sealed dressing to remove fluids and infectious materials and to aid healing of wounds with a total surface area of less than or equal to 50 cm2. The procedure is intended to hasten healing for decubitus ulcers (pressure sores) and other slow-healing or nonhealing wounds.
Service type: Wound care – negative pressure wound therapy (small surface area)
Typical site of service: Outpatient wound care clinics, physician offices, hospital outpatient departments, and skilled nursing or long-term care facilities where small-area negative pressure therapy is delivered.