How much does Medicare pay for CPT 97597?

Medicare allowed an average of $74.53 per service and paid $57.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $182.28, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 97597?

Removal of tissue from wound, 20.0 sq cm or less. It was billed 579,628 times to 201,628 Medicare beneficiaries by 5,884 providers in 2024.

Does 97597 pay differently in an office than a hospital?

Yes. The allowed amount averaged $93.49 in an office setting and $32.64 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 97597 most?

Podiatry, with 264,372 services from 3,126 clinicians. Next are Nurse Practitioner, Family Practice, General Surgery.

CPT 97597

Removal of tissue from wound, 20.0 sq cm or less

$74.53Medicare-allowed amount per service, averaged across 579,628 services

Providers submitted

$182.28

Asking price, not received

Medicare allowed

$74.53

The fee schedule figure

Medicare paid

$57.31

Balance is patient coinsurance

Providers submitted an average of $182.28 for this code and Medicare allowed $74.53 — 2.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $57.31 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $93.49
Hospital / facility: $32.64

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 398,959 services were billed in an office setting and 180,669 in a facility.

Services: 579,628
Beneficiaries: 201,628
Providers billing it: 5,884
Total allowed: $43,199,675

What Medicare pays for CPT 97597

Across 579,628 services billed by 5,884 providers to 201,628 beneficiaries, Medicare allowed an average of $74.53 per service. That is 2.9 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 97597

Specialty	Services	Beneficiaries	Avg allowed	Providers
Podiatry	264,372	99,177	$93.38	3,126
Nurse Practitioner	65,432	25,500	$39.03	822
Family Practice	65,224	19,153	$72.02	433
General Surgery	52,557	15,896	$58.28	365
Emergency Medicine	21,460	8,087	$39.37	180
Internal Medicine	21,177	6,668	$58.91	162
Physical Therapist in Private Practice	15,078	1,849	$97.66	44
Physician Assistant	13,912	5,406	$45.71	182
Infectious Disease	12,294	2,743	$68.12	64
Vascular Surgery	6,070	2,188	$53.45	75
Dermatology	5,693	2,854	$103.47	98
Plastic and Reconstructive Surgery	5,430	2,231	$60.94	61
General Practice	4,654	1,320	$76.79	31
Undersea and Hyperbaric Medicine	4,613	1,745	$42.46	53
Occupational Therapist in Private Practice	3,415	640	$93.70	28

97597 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	78,628	$87.06	$66.98	641
California	51,675	$88.44	$62.61	426
Texas	41,807	$79.74	$63.99	371
New York	39,525	$99.79	$69.40	428
Pennsylvania	34,311	$73.53	$56.71	343
Illinois	31,993	$76.55	$58.07	315
New Jersey	20,745	$86.84	$60.77	229
Massachusetts	14,952	$65.08	$47.06	147
North Carolina	14,414	$60.23	$48.47	182
Oklahoma	13,879	$61.44	$52.22	87
Tennessee	13,810	$65.15	$55.35	127
Georgia	13,584	$63.66	$51.65	155
Virginia	11,882	$70.52	$53.86	145
Maryland	11,768	$81.68	$59.47	142
Ohio	11,716	$67.54	$54.35	170
Missouri	11,375	$51.92	$43.18	120
Iowa	10,334	$49.34	$40.37	82
Kentucky	10,159	$58.67	$48.52	83
Michigan	10,153	$67.60	$52.92	150
South Carolina	10,019	$59.27	$48.23	89
Wisconsin	9,973	$62.75	$50.09	132
Arizona	9,461	$72.62	$57.03	131
Indiana	8,080	$61.30	$50.65	108
Wyoming	7,146	$86.44	$66.95	26
Washington	6,886	$64.56	$47.89	88
Alabama	6,600	$56.89	$50.08	71
Minnesota	6,541	$67.31	$50.84	76
Kansas	6,354	$43.23	$36.00	66
Connecticut	5,720	$66.82	$47.93	77
Delaware	4,689	$54.44	$42.15	35
Colorado	4,208	$77.18	$58.43	67
Louisiana	3,884	$60.04	$50.13	63
Rhode Island	3,749	$51.23	$37.62	25
Utah	3,701	$68.75	$54.81	47
New Hampshire	3,331	$43.66	$32.82	30
Nebraska	3,245	$58.61	$47.39	33
Oregon	3,128	$62.69	$48.29	49
Mississippi	3,002	$63.59	$56.82	33
Montana	2,886	$57.85	$44.26	32
Idaho	2,779	$45.52	$37.96	38
Nevada	2,758	$75.88	$60.43	36
Arkansas	2,693	$64.69	$56.55	43
New Mexico	2,073	$52.80	$42.99	28
South Dakota	2,059	$40.34	$31.76	15
West Virginia	1,636	$66.15	$53.77	21
North Dakota	1,495	$54.32	$42.13	20
Maine	1,455	$47.55	$36.59	18
Hawaii	814	$73.57	$53.60	14
District of Columbia	623	$74.80	$50.40	10
Vermont	545	$57.87	$44.54	10
U.S. Virgin Islands	323	$99.44	$73.96	1
Puerto Rico	307	$39.23	$31.26	2
Northern Mariana Islands	280	$92.99	$78.57	1
Alaska	277	$84.51	$57.48	4
XX	198	$99.09	$78.00	2

Related codes

97530Therapy procedure$31.54
97535Training for self-care or home management$25.35
97533Therapy procedure$52.00
97598Removal of tissue from wound$33.10
97542Evaluation for wheelchair$23.83
97550Caregiver training in strategies and techniques to facilitate the pati$51.87
97537Training for community or work reintegration$24.91

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.