CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31
CPT 97605 RVU and Medicare Payment (2026)
Neg prs wnd ther dme — 0.54 work RVU, about $42.09 non-facility Medicare payment at the 2026 conversion factor.
- Work RVU
- 0.54
- PE RVU (non-facility)
- 0.71
- PE RVU (facility)
- 0.08
- MP RVU
- 0.01
- Office payment
- $42.09
- Facility payment
- $21.04
How the payment is calculated
Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 97605 in a non-facility setting with national GPCI: (0.54 + 0.71 + 0.01) × $33.4009 ≈ $42.09. The same code in a facility setting pays about $21.04 because facility PE RVU (0.08) replaces office PE RVU.
What changes by locality
GPCI moves 97605 non-facility payment from $38.58 to $54.4 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.
Related codes
Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.
Frequently asked questions
What is the 2026 work RVU for CPT 97605?
0.54. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.
How much does Medicare pay for CPT 97605 in 2026?
About $42.09 non-facility ($21.04 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.
Does the work RVU change between office and facility?
No. Work RVU (0.54) and malpractice RVU stay fixed; only practice expense changes (0.71 office vs 0.08 facility). That is the entire office-vs-facility payment gap.