CPT 97598 Physical Therapy/Rehab
Dbrdmt opn wnd addl 20cm/< Cost
Body System: Musculoskeletal
Medicare Facility Rate
$22
CMS PFS CY2026
Medicare Non-Facility Rate
$48
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
0.49
Work RVU
0.10
Facility PE RVU
0.06
Malpractice RVU
1.43
Total RVU
Frequently Asked Questions
How much does Dbrdmt opn wnd addl 20cm/< cost?
The Medicare facility rate is $22. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Dbrdmt opn wnd addl 20cm/< cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $22.